It may seem an odd expertise for a pharmacist, but when it comes to games such as Candy Crush or Bubble Pop, Katherine Hoover knows her stuff.

鈥淵ou鈥檇 be surprised how addicting popping bubbles can be,鈥� she says pulling up a colorful screen with floating bubbles on her smartphone. It鈥檚 an app she uses with some of her patients who come to her for counseling and support in their struggle to stop smoking. Small tricks work, she says. She鈥檇 much rather they substitute an addiction for popping bubbles to manage their cravings than to have them grab a pack of cigarettes.

Passionate about what she does, the pharmacist believes in patients even when they鈥檝e lost the ability to believe in themselves. She teaches them tricks to make quitting stick. 鈥淓very quit attempt is a new chance to make it work again. Often you just need someone to coach you through the hard parts, someone who鈥檚 completely neutral and objective.鈥�

Hoover, PharmD, is part of聽聽housed at the聽. She wants to help all smokers quit, particularly those with cancer. Since 2010, with funds from the state cigarette surtax funding, Hollings Cancer Center has recruited 23 nationally-recognized cancer experts and initiated 15 pilot projects that have led to innovative clinical trials. Research at Hollings and other cancer centers continues to illustrate how essential it is to help smokers be successful in their quit attempts, she says.

One of every three cancer deaths in the nation is linked to smoking. Smoking decreases the success of surgery, chemotherapy and radiotherapy. It increases the chance of cancer recurrence, having side effects from cancer treatment, developing a second cancer and having other health problems. Though most people are familiar with its effect on lung cancer, with smoking causing almost nine out of 10 cases, many aren鈥檛 aware of its links to other cancers.

According to Surgeon General鈥檚 Reports, in addition to lung cancer, smoking also affects acute myeloid leukemia and cancers of the trachea and bronchus, oropharynx, esophagus, larynx, stomach, bladder, kidney and ureter, pancreas, uterus and cervix, colon and rectum, and liver.

Hoover says most smokers understand it鈥檚 doing harm, but understanding the problem and overcoming an addiction are completely separate issues. That was Deborah Giles鈥� dilemma. Smoking three packs a day for decades, she had tried to quit before. She got so irritable and depressed, her family actually begged her to keep smoking. Giles had resigned herself to a life restrained by smoking, until she got a scare that she had a mass that might be cancerous.

It turned out to be a 鈥渓ittle emphysema鈥� and while this wasn鈥檛 a cancer diagnosis, it brought back nightmares she had of an aunt who had to be on oxygen and experienced a poor quality of life at the end. 鈥淪he had emphysema and just could not give up cigarettes. When I saw how my aunt suffered 鈥� it was like she literally was suffocating to death 鈥� I knew I didn鈥檛 want to end up like that. I didn鈥檛 want to put my family through that. But I didn鈥檛 know if I could do it,鈥� Giles says.

She had seen an ad for the Tobacco Treatment Program, so she decided to see what it offered. As a safeguard, she left her cigarettes in the car so they wouldn鈥檛 be confiscated. She didn鈥檛 have much confidence it would help and almost backed out, but then she remembered her aunt. 鈥淚 believe that God put that clinic in my life, and he put Katie in my life,鈥� she says of the relationship she would develop with Hoover, whom she calls 鈥榤y Katie person.鈥�

Hoover says the right set of circumstances aligned. Giles, 65, now tobacco free for two years, was willing to come in weekly. She got all the medications on board to lessen the cravings and her recent cancer scare gave her enough motivation to stick to the game plan they made together.

A critical part of the interventions Hoover does with patients is to identify triggers that prompt cravings and to have pleasant activities that can be used as distractions. In addition to app games, she encourages smokers to carry stress balls that can be tossed back and forth between the hands to engage both sides of the brain. There also are meditation apps and classical music playlists that can be used.

Another critical component: medications. It鈥檚 not just a matter of willpower, Hoover says, but rather an addiction that has to be broken. It takes people generally seven to 10 attempts on average to quit. 鈥淚f they keep trying, it will work.鈥�

Hoover guided Giles through the agony of breaking the addiction, helping her navigate strong smoking cravings and environmental triggers. Giles says it was the first time she felt empowered. Meeting with Hoover once a week for three months, Giles used Wellbutrin, patches and nicotine gum to help lessen urges as well.

Before this program, doctors had urged her to quit, Giles says. 鈥淚t鈥檚 easy for a doctor to say cigarettes are going in the trash. You can鈥檛 just throw them out. It鈥檚 like a drug, and you鈥檙e an addict. It doesn鈥檛 work like that.鈥�

Giles learned how to identify her triggers, monitored how many cigarettes she was smoking each day, used her medications and finally did the ultimate. Eleven days after starting the program, Giles felt ready to quit. She trashed her cigarette packs, lighters and ashtrays. When she was able to go four days without smoking and without killing anyone, she was floored, she says. When she was tempted to light up, she remembered the agony of her worst days.

鈥淚 told myself, 鈥榊ou鈥檝e come through too many tough moments to go back now.鈥欌��

Giles hopes to inspire other smokers to quit. The emotional support she received from the program and her family were critical to her success, she says. Giles knew that Hoover would never give up on her, and she reenlisted the help of her family, including her daughter Amanda Giles. 鈥淪he was pretty much ready to throat punch people,鈥� Amanda says, smiling at her mom, describing how she鈥檇 pick up on the clues that her mom was suffering from cravings, because she鈥檇 start wringing her hands. 鈥淚 knew I needed to be extra kind and do something to help her get through those moments.鈥�

Amanda, who attended many of the counseling sessions, found Hoover was as far from a drill sergeant as could be. She and her mom had imagined some kind of boot camp training, but it turned out to be nothing like that. 鈥淜atie is one of a kind. She鈥檚 the ultimate cheerleader. Every minute step you take becomes the biggest accomplishment. If you drop one little number,鈥� Amanda says, referring to her mother鈥檚 carbon monoxide readings, 鈥渋t鈥檚 the biggest thing to her. No accomplishment is too small. She doesn鈥檛 just tell you that. She shows you that.鈥�

Now Giles can鈥檛 stand the smell of cigarettes. She鈥檚 proud that she hasn鈥檛 touched a cigarette for two years, and for the first time in more than 40 years, smoking no longer rules her life. She doesn鈥檛 have to leave dinners or family events to go out and smoke. She also feels better and knows she鈥檚 bettering her odds of avoiding many of the conditions smoking is known to cause.

鈥淚鈥檓 not as short winded. I have a better outlook. I don鈥檛 feel I鈥檓 as chained to something. It helps my breathing, lungs and heart,鈥� she says. 鈥淚t feels amazing 鈥� absolutely amazing.鈥�

Giles wants other smokers to know their next quit attempt, no matter what their age or how much they may have smoked, may be the magic one.

鈥淚f I can quit, anyone can quit.鈥�

Her daughter, a smoker, nods. 鈥淚f she can quit, Yul Brynner could have quit.鈥� Amanda, 36, says seeing her mother quit is inspiring her to try again. This time, she knows she鈥檒l have Hoover to help. 鈥淚t鈥檚 not like you鈥檙e quitting alone. It鈥檚 like you鈥檙e quitting with your best friend.鈥�

For more information, contact the Tobacco Treatment Program at 843-792-9101.