About 100 high-school students in the St. Louis area are finishing the school year knowing they can tackle great obstacles, make sacrifices and reach a goal that will lead to a healthier lifestyle. All of them made the commitment to quit smoking.

Some who began the eight-week smoking-cessation program through BJC Health System were two-pack-a-day smokers. More than one-third of the students in the program say they now are smoke-free. The others have drastically reduced the number of cigarettes they smoke daily. For an hour each week they have met as a group with a BJC community-school health educator at their school. The program ran at Pattonville Positive School, Hancock Middle and High schools, Lindbergh Academy, Cleveland NJROTC Academy, Seckman High School and Fox High School. Through the support-group sessions, students not only learned about the dangers of smoking but also how to take charge of their lives. They learned how to put mind over matter. Willpower, stamina and self-confidence occupied their attention for two months. For some of the students, it was the biggest hurdle they had tackled as teen-agers. The students learned the top 100 reasons to quit smoking. They met and spoke to a man who lost his larynx from cancer due to smoking. They looked at a badly diseased lung from a smoker. Many of the students have overcome peer pressure and the urge to look cool with cigarettes. Now they serve as role models for other teen smokers who want to quit. In an effort to develop coping and problem-solving skills needed to stop smoking, about 60 students in the program recently took a field trip to Jefferson Barracks Park for a Teen Challenge. The event, which was co-sponsored by BJC and the Missouri National Guard, provided team-building and conflict-management activities that challenged students to creatively solve physical challenges. Among the challenges the students faced were: The Mine Field, where students had to coach blindfolded team members through a maze of obstacles; the Poison Peanut Butter Pit, where the team determined how to travel a lengthy distance walking on top of three small boards; the Spider Web, in which teams had to successfully get through a maze of ropes without getting trapped; the Trolley, where team members learned to move in sync with one another; All-Aboard, where team members figured out how all of them can stand on a small foundation. Pattonville Positive School's greatest success story was told by Andy Dean, a senior who had been smoking up to two packs a day until he quit about eight months ago. After smoking for about five years, he decided to join the smoking cessation program. Andy's initial intention was to cut down, not quit. But after hearing how smoking affects the body and seeing a cancerous lung, he decided to quit. "I didn't want my lungs to look like that," says Andy. "I'm through with cigarettes now." Like many of the students, Andy didn't go cold turkey. "First I cut back to 10 a day, then five and then I stopped," says Andy. "I've got some of my friends to stop smoking and a lot are thinking about quitting because they saw me quit." Andy notices a marked improvement when he plays hockey these days: "I can breathe easily and can play longer." Shirley McCain, the school nurse at Cleveland NJROTC Academy, said 11 students there had started the program. Five have quit smoking, and six have cut down. She has watched the students gain control of their lives in more areas than smoking. She has watched them build relationships and become more conscientious. "These students have sacrificed a lot," says McCain. "Some were teased by friends but they were able to sustain peer pressure." As 19 students piled into the cafeteria at Hancock High School for their last session of the program, they were treated to Krispy Kreme doughnuts, chocolate milk and orange juice for their efforts. Also on the table were items they could help themselves to at every meeting: a pack of straws, bubble gum and blow pops. They used these items to help them through the urge to have something in their mouths. At their last session, students went around the room naming the top ways to quit smoking. Those included: chewing a lot of gum, being at places that don't allow smoking, believing that you can do it, playing sports and playing Nintendo and staying away from smokers. For those who hadn't quit, Boyd pushed them to set a date to become smoke-free. Kim Martin, 15, a freshman at Hancock High School, is smoke-free after three years of procrastinating. "Before I came to the group I always said I'd quit tomorrow but I never did," said Kim. "I learned you just have to try." Diana Wilhold has run BJC's smoking-cessation program for teens for the past three years. In that time, the program has helped more than 150 students act on their desire to quit. She attributes the success of the program to the facilitators. "You have a person who is invested and who cares for them," said Wilhold. Many of the students form special bonds with their facilitators because those adults learn about the life of each student and help each one learn to cope with daily stress in a positive way. Not only do they help students quit smoking, but also they boost self-esteem, recognize students for their successes and help them cope with challenges in their personal lives. "What you think about yourself is huge in how your life is going to turn out," facilitator Andi Boyd told her group at Hancock High School earlier this month. Facilitators become mentors for the students in the program and are committed to them even after the program ends, said Wilhold. To support students during the summer, facilitators are organizing informal sessions outside of school. Groups will meet to talk about challenges they're facing when they have more unstructured time on their hands. Boyd, the school-community health educator at Hancock, provided the emotional support Krissy Coleman needed this year in her effort to quit smoking. Krissy, a junior, has smoked up to 1 1/2 packs a day since she was 8 or 9 years old, she says. Now she's down to one cigarette a day and has picked a date to quit altogether. "She taught me that you've got to be more powerful than the addiction," said Krissy. "After hearing all about the dangers, you just say 'eeww.'"

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