Smoking Cessation: Addressing A Health Crisis In The Commonwealth of Kentucky

I was compensated by Med-IQ through an educational grant from Pfizer, Inc. and the Coverys Foundation to write about smoking cessation. All opinions are my own.

Hey, y'all!

In today's post, I want to get personal. I want to have a difficult conversation. I want to address a health issue that plagues many of us -- our communities, our families -- around the world, in our country, and in the Commonwealth of Kentucky: smoking.

For those of y'all that don't know, I am from Southern Kentucky. My community is rural and chock-full of the best people you'll ever meet. While the vast majority of good, important life lessons were instilled in me during my youth, a few were not pleasant. The first one that comes to mind? The normalization of smoking.

Context: My family's farm, Phelps Acres Farm, grew & harvested tobacco for decades, just as many did in my region of Kentucky.

Many of my family members have either smoked or currently smoke. And in full disclosure: I was chainsmoker in the past, as well; I picked up in the habit in college. There are many reasons as to why one should be dissuaded from smoking; however, I'd like to share some very personal reasons.

My Grandfather, the late John D. Phelps, had a bilateral lung transplant. My other Grandfather, the late Terry D. Sullivan, had a plethora of cardiac and pulmonary issues. My late Grandmother, the late Linda Sullivan (my precious Nanny - I loved her so much, y'all) - had multiple heart attacks and lung cancer. This is unfortunately not an all-inclusive list in regards to my family, but it breaks my heart to even list this many.

The synopsis? Smoking has taken away so many of my loved ones; while habits can be changed and replaced, lives cannot.

When I was getting my MBA, we read a book about having difficult conversations. That discussion and lesson has stuck with me to this day. So, y'all, let's talk about it. Let's have a difficult conversation.

So, You Smoke Cigarettes And/Or Vape E-Cigarettes. Where Should You Start The Cessation Journey?

I. Reach out to your healthcare provider

Smoking cessation is not an easy task, but it is one that is completely doable. It is recommended that you consult with your healthcare provider on this process, as they are trained and well- equipped to help you. While many people try to quit on their own, few are successful; medications and counseling significantly increase your chances of quitting successfully.

II. Call the toll-free Quitline (1-800-QUIT-NOW)

Each state has a Quitline that you can call; when you dial the above number, it will connect you to the appropriate line. Quitlines provide free counseling, print resources, and local referrals; additionally, many provide access to smoking cessation medications at no cost. This is a very powerful resource that I implore y'all check out.

III. Check out quit smoking web/text resources

At http://smokefree.gov, many resources are available for smoking cessation. Research and preparation are necessary in making this life-altering decision; the linked website is a great place to start!

Professional Insights:

In partnering on this campaign, I must confess: I have learned so, so much y'all. The two medical professionals that led the education are powerhouses: Dr. Jodi Prochaska, PhD, MPH is a Professor of Medicine at Stanford University; Dr. Hilary Tindle, MD, MPH is an Associate Professor of Medicine at Vanderbilt University. I am honored to relay some insights that Dr. Prochaska + Dr. Tindle shared:

I. The combination of counseling + use of smoking cessation aids like nicotine replacement therapy (patches, gum, lozenges, inhalers, or nasal spray) and/or prescribed smoking cessation medicines (Chantix/Varenicline and Zyban/Wellbutrin/Bupropion) is the best strategy. In fact, combining counseling + medication, compared to using no quit aids, can double or even triple cessation success rates.

II. Based on current evidence, nicotine vaping or the use of e-cigarettes is not a recommended path to take in quitting smoking. E-cigarettes went straight to market without regulatory review of safety and efficacy; they are not approved by the Food & Drug Administration as a therapeutic (a way to quit smoking) and they have not gained approval as a reduced-harm tobacco product

III. Using FDA-approved nicotine replacement products is not trading one addiction for another. Nicotine replacement products are used to catalyze a long-term lifestyle change, better enabling an individual to quit smoking successfully. For example: people do not get addicted to nicotine patches, which provide a slow, steady delivery of nicotine throughout the day (delivered via the skin into the bloodstream to the brain).

IV. Smoking is especially dangerous in the midst of the current global pandemic, COVID- 19. People who smoke and get COVID-19 tend to have more severe cases, as they both harm the pulmonary system. Said differently, it's a "double-whammy". Furthermore, touching one’s face is to be avoided during the pandemic, and if you are smoking and/or vaping, you are repeatedly bringing your hand to your mouth, thereby possibly exposing yourself to greater risk of infection.

How To Have A Conversation With A Family Member/Friend About Quitting:

Most smokers - including myself, when I started smoking - know that smoking is an extremely unhealthy habit. Many experience shame in regard to the habit, along with feeling guilty and being constantly judged. I say that from personal experience. It is thus important to approach this difficult conversation with care, love, and caution -- a correctly-framed conversation could be the kickstart that your loved one needs.

I. Ask open-ended questions. This will enable you to understand the perceived benefits/utility that the smoker in your life receives from the habit. Knowing this will be an important part in understanding how one can pivot; if, say, it's a social thing - what healthy habits could be implemented in their life, eliminating the smoking, yet not detracting from their social life?

II. Take a long-term/big-picture approach. What does your family member or friend look forward to in life? Maybe it’s a trip abroad, spending time with grandchildren, or staying healthy enough to care for someone in need. Is smoking/vaping getting them closer to those goals? If not, it may be time to make a change.

III. Recognize and build upon "change talk". Change talk is communicated in the form of pros/cons such as “I really like smoking, but I don’t like paying $10 for a pack”, “I like smoking, but I don’t like the smell”, or “I quit smoking in the past and I know I can do it again if I put my mind to it.” Building on expressed motivations for change and past successes with behavior change (either quitting smoking or making other changes in one’s life) can help support movement toward becoming tobacco-free.

Resources:

1. Centers for Disease Control and Prevention: How To Quit Smoking
2. The Truth Initiative: Inspiring Tobacco-Free Lives
3. Smoke Free: Speak To An Expert
4. FDA-Approved Smoking Cessation Products
5. Smoking Cessation: A Report From The Surgeon General
6. Consumer Guide: Smoking Cessation
7. Centers for Disease Control and Prevention: Smoking Cessation + E-Cigarette Facts
8. Smoking Cessation by the Numbers

Links to external sites are provided as a convenience and for informational purposes only. They are not intended and should not be construed as legal or medical advice, nor are they endorsements of any organization. Med-IQ bears no responsibility for the accuracy, legality, or content of any external site. Contact the external site for answers to questions regarding its content.

I believe in a healthier Kentucky; I want a healthier Kentucky; I hope for a healthier Kentucky; I know that one way that this can be achieved is by having difficult conversations regarding smoking cessation. Tobacco use is a threat to our Commonwealth, our family, our friends, and our loved ones -- won't you join me in fighting this?

We can do this, Kentucky. As our state motto says: "United We Stand, Divided We Fall."

Want to get started? An immediate way in which you can catalyze change is by participating in the following survey. The purpose of the survey is to share insights with medical professionals on this topic to improve healthcare communication with patients.

Med-IQ is conducting an anonymous survey and would appreciate your input. The survey, which includes additional education on this topic, will take less than 10 minutes to complete. Survey responses are shared only in aggregate.

Your responses to these survey questions will provide Med-IQ with important information about your views on and experiences with smoking cigarettes and vaping e-cigarettes. Your responses will be used to identify additional opportunities to help people stop smoking and vaping and educate their healthcare providers.

Once you've completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 10 $100 VISA gift cards. If you choose to enter, email addresses are used only to randomly draw the winners and notify them of their prize. 

Y'all come back now, ya hear?

My best,

JC