Thursday, January 6, 2022
Everyone’s New Year’s resolutions are well underway. For those looking to stop using tobacco products in the New Year, it’s especially important to do so in the era of COVID-19.
Debi Hudson Buckles, the IU Simon Comprehensive Cancer Center’s tobacco control program director, said people who smoke or vape are at a higher risk of getting COVID-19, partially because they bring their hands to their mouths more frequently.
Further, researchers have found that among patients with the virus, individuals who currently smoke or previously smoked had nearly double the risk of the disease getting worse, compared to non-smokers.
“Smoking and vaping have been shown to negatively affect the lungs and the immune system, putting those who smoke or vape at a greater risk of becoming infected and having worse outcomes from COVID-19,” Buckles said. “Cancer treatment can also weaken the immune system, increasing the risk of infection and worse outcomes for patients.”
Buckles, who has spent more than two decades helping people overcome their tobacco addiction, offers these tips.
Q: What do you think is the most important thing for people to do to succeed at ending tobacco use?
Buckles: Plan properly and get professional help. Many people think they can quit with sheer willpower alone, but only a few do. There are proven methods that increase success rates and make the process less taxing. Success rates are much better for people who use medication and who get counseling at the same time.
Q: How does counseling help?
Buckles: Everyone’s tobacco habits are different and prompted by triggers specific to them. That’s not to say that many people don’t share the same triggers — such as smoking after a meal — but habits are personal, and so are the needs of the individual breaking a habit. Counseling helps a person learn new coping strategies for habits and how to compensate.
Counseling professionals will talk with the individual to figure out personal strengths and weaknesses and the severity of the addiction. Points to consider include why they started using tobacco; when the individual smokes the most; what tobacco product is used; have there been previous attempts to quit using tobacco and what event doomed those attempts. By identifying triggers in a person’s routine, it is easier to plan strategies to counteract those triggers. Other things to consider are the individual’s medical history, other addictions and mental health history.
Q: You are a proponent of using medications to help with tobacco cessation. What are those medications and which ones are best?
Buckles: Often, patients are concerned about using these medications because they don’t want to put anything else in their body or are fearful of the side effects. It’s important to remember that cigarettes contain more than 6,000 chemicals, however, these medications have far fewer and are much safer than the tobacco product they are presently using. Additionally, these medications are typically only used for a few weeks to reduce the withdrawal symptoms. If cigarettes were coming to market today, they would never gain FDA approval, yet these medications have had to go through the rigorous FDA process to be able to be on the market.
Currently, there are seven FDA-approved tobacco cessation products on the market. No one medication is best for everyone. Some of these medications include nicotine. It’s important to note that nicotine is not what causes the negative health effects from smoking, but it is what brings tobacco users back to these products. Some of these medications don’t contain any nicotine but instead change how the brain reacts to nicotine. Deciding which medication will be most beneficial for an individual is one of the things a professional tobacco treatment specialist can help determine as well as the most effective dosage to counter the individual’s tobacco addiction.
A tobacco treatment specialist also can instruct a person on how to properly use the cessation medications. For instance, to be most beneficial, the nicotine gum should not be chewed only, but should be chewed until the user feels a tingling sensation and then "parked" between the gum and cheek so the nicotine can be absorbed. Also, the user should not eat or drink 30 minutes before or while using the gum. Another common misconception is that the nicotine inhaler should be inhaled. The inhaler is actually most effective if the vapor is held in the mouth to absorb the nicotine. The five remaining medications include the nicotine patch, nicotine lozenge, nicotine nasal spray, Bupropion (Wellbutrin) and Varenicline (Chantix). These last two medications don’t contain nicotine and are prescription only.
Q: Are e-cigarettes a good tool for stopping smoking?
Buckles: There is much debate in the public health field today, but it is my belief that e-cigarettes are just another way to get people hooked on nicotine. There currently isn’t enough information to show they are a way to wean off nicotine. E-cigarettes are a tobacco industry product and are not regulated. Scientific testing showed that 74% to 90% of the e-liquid on the market that reportedly contains no nicotine actually does. The FDA only regulates the e-liquid that contains nicotine. In addition, these products have not been FDA approved as an aid to quitting.
Q: Speaking of weaning, do you recommend quitting cold turkey or taking a period of time to reduce cigarette use?
Buckles: That is a very individual choice. Some people are better at making a plan and sticking with it. Others need to simply quit without a period of moderation. A tobacco treatment specialist can help an individual decide which would be most beneficial. If one has been successful previously with strategically cutting down, then that would be a good option. However, some people just know they can’t do that and need to set a date.
Q: What are some common triggers and ways to thwart the urge?
Buckles: Mealtime is a common trigger. Instead of lingering at the table, get up and do the dishes, brush your teeth, go for a walk or eat something containing cinnamon. Many people say cinnamon and tobacco do not go together. Driving is another common trigger. Pack a stress ball instead of cigarettes, or take a straw to chew on. Once again, enjoy a treat flavored with cinnamon.
Other tips include avoiding alcohol, avoiding social scenes you associate with smoking, substituting juice or tea for that morning cup of coffee. And remember exercise is your friend because it produces chemicals in the brain that improve moods and serves as a reminder that not smoking makes you healthier. Using some of the medications mentioned earlier can also help.
Q: Where can one find a smoking cessation counselor?
Buckles: Indiana has a free tobacco quit line, which can be reached by dialing 1-800-Quit-Now (1-800-784-8669). Highly trained coaches will provide help to any tobacco user. Callers can get four weeks of free patches and gum or lozenges to begin their journey to a healthier lifestyle.
Q: Do you have any other tips to share?
Buckles: There’s no time like the present, so don’t procrastinate once you set a date to quit. Don’t think about stopping as a mountain you need to climb; instead think of it as a series of short hikes. Take it one hour or one day at a time and the resolution seems much less daunting. Also,
- Be more active. Exercise releases feel-good chemicals in the brain which can help you overcome mood swings that can be caused by the lack of nicotine. Be aware of one of the rewards of stopping: Within as little as a week, you may notice more endurance for walks or other forms of exercise.
- Set smaller goals and focus on completing them. A goal may be as simple as resolving to walk a half-mile every morning at the time you normally reserve for coffee and a couple cigarettes.
- Treat yourself: Bank the money you normally would spend on cigarettes and use it to buy something else you want.
- Share your story with those who will support your efforts to stop using tobacco. A strong support system can be very beneficial.
