Smoking harms nearly every organ in the body. It causes about 1 in every 5 deaths in the United States each year, and is the main preventable cause of death and illness. We know the harmful effects of tobacco, so why is it so hard for people to quit?
鈥淭he benefits of not smoking, in particular to the heart, are huge. And with February being American Heart Month, it鈥檚 a good time to think about quitting,鈥 said the University of Louisville鈥檚 Rachel Keith, Ph.D., APRN, a specialist in cardiovascular medicine and tobacco treatment. 鈥淏ut it鈥檚 a lot more than just halting a bad habit. That鈥檚 why we can say our relationship with tobacco is, 鈥榗omplicated.鈥欌
Keith, who runs the new UofL Physicians Tobacco Treatment Clinic, said there are 鈥渟trange dynamics鈥 with tobacco.
鈥淪moking cessation is hard in general,鈥 she said. 鈥淗elping patients to quit smoking often involves a lot of talking and figuring things out.
鈥淲e have to really get at WHY they smoke. Perhaps their grandmother died at age 100 even though she smoked, so they don鈥檛 believe there鈥檚 a connection. Or, she got them smoking and that鈥檚 their connection to her now that she鈥檚 gone.鈥
She said many people who come to the clinic have smoked for 30 or 40 years, and they are hesitant to quit. 鈥淭hat鈥檚 because it鈥檚 almost a part of them. In their view, you are taking away something they don鈥檛 know how to replace.鈥
She said she encourages patients to try different things and look for healthier alternatives when they have the urge for a cigarette.
鈥淏ut when I ask them, 鈥榃hat are some other things you like to do for 10-15 minutes?,鈥 a whole lot of people can鈥檛 name those things. Many don鈥檛 have anything else. We try to help them find them, whether it鈥檚 a hobby or something like taking a walk,鈥 she said.
But again, it鈥檚 complicated.
鈥淎 lot of patients feel sick, so they think they can鈥檛 get out and walk, even though they know it will be easier when they quit. There鈥檚 just a lot that goes into smoking, culturally and hormonally.鈥
People 鈥渃an鈥檛 see the immediate effects of quitting, but they can quickly gain the rewards of smoking, because it鈥檚 almost instant. The body actually gets hard-wired to anticipate the effects from tobacco.鈥
That鈥檚 why the new clinic approaches all the factors that make it hard for people to stop, making it Louisville鈥檚 only comprehensive tobacco treatment program.
Keith meets with patients and develops a personal, individualized approach that best suits each patient鈥檚 needs. During sessions, Keith and patients discuss the benefits of stopping smoking, medication options, and different skills, such as mindfulness and relaxation, to help overcome anxiety.
Medications to treat withdrawal symptoms are paired with the cognitive-behavioral therapy to help patients sustain attempts to quit. Any medical issues also are addressed. One treatment Keith is studying is how to increase people鈥檚 motivation with virtual reality therapy, where an immersive session allows patients to imagine what life will be like once they鈥檝e quit.
鈥淭he good news is, this type of program has been proven over and over as the most effective method for long-term cessation,鈥 Keith said. 鈥淏ut until we opened, it was hard to find one in this area to get into.鈥
She said those who try to quit on their own have about a 6 percent chance of succeeding. If they work with a health provider, their chances improve to 10 percent to 15 percent. But with the comprehensive program, patients see a success rate of 30 percent and above.
鈥淭hose who have come through the program have done really well,鈥 she said. 鈥淎lmost everyone who comes through has quit.鈥
It generally takes about six sessions, usually once a week or every other week, to complete. Afterward, patients return on a more limited basis, and Keith follows up by phone.
Anyone who wants to quit smoking can come to the clinic, and many insurance plans will cover the program at little or no cost to the patient. It is located in Suite 310 of the UofL Physicians Health Care Outpatient Center, 401 E. Chestnut St.
To make an appointment, call 502-588-4600.