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Friday October 24th 2014

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Kicking the Sticks

Local Hospitals Step Up Anti-Smoking Initiatives
By Sarah McCartan

The risks of tobacco use are certainly no secret, nor are they highly debated. On the contrary, tobacco products wear their risks loudly on their labels.

These risks are perhaps even more loudly proclaimed by the number of individuals that suffer from smoking-related diseases—totaling at more than 16 million Americans, according to the Department of Health and Human Services.

The Food and Drug Administration is launching a new campaign targeted at teenagers, geared more toward the immediately digestible risks, opposed to lifelong repercussions. The messaging highlights the cost of cigarettes in relation to the risk of gum disease, making note that the price of these packs could quite literally cost you your teeth.

Still, it doesn’t stop at advertising campaigns or with widely targeted initiatives. In recent years, a growing number of companies have taken greater strides to expel the use of tobacco products—from various private establishments banning patrons smoking on or around their premises, to the recent overhaul at drugstore CVS, who announced earlier this year that their stores will stop selling tobacco products by Oct. 1.

In the health care world in particular, a number of organizations are “kicking the sticks” too, and banning the use of tobacco products on their campuses.

On the Local Front
According to the American Nonsmokers’ Rights Foundation, it’s reported that at least 3,810 local and/or state/territory/commonwealth hospitals, healthcare systems and clinics have adopted 100 percent smoke-free campus grounds policies. On a local front, this includes Baptist Health Care and Sacred Heart Hospital.

As of this year, the two have banded together to take their own smoke-free campus policies even further and are now working from the inside out, having adopted a newly implemented tobacco-free hiring process, effective Jan. 1, 2014.

According to Darlene Stone, Vice President of Human Resources and Chief Human Resources Officer of Baptist Health Care, many factors came into play for this policy decision. For Baptist, the first and foremost being adopting a policy that aligns with the hospital’s mission statement.

“First, we are a health care organization whose mission is to improve the health of our community. Tobacco use leads to disease and disability,” she said.

In addition to this policy acting in support of the ever-growing number of alarming smoking-related statistics, the move supports the Community Health Needs Assessment conducted by the Partnership for a Healthy Community.

This particular assessment showed tobacco use as number one on the list of the top risk factors that member organizations will focus on to improve the quality of health in our community. Tobacco use is followed by healthy weight, a focus on increasing physical activity levels and improved nutrition, and health management, or the management of personal health and improved access to appropriate health services.

Although Baptist has offered smoking cessation programs and resources to employees as a part of their “Healthy Lives” initiative for quite some time, the hospital recognized they were still bringing tobacco users on board as organizational employees, a move that was counterproductive to promoting community health.

“Our own population’s risk factors show tobacco use as a concern. While we were working with our team members offering free tobacco cessation programs, we were hiring an equal number of tobacco users into our system as new hires,” Stone said.

Across town, Sacred Heart Hospital has been a “tobacco free” campus since 2010. However, like Baptist, this is the first time that the tobacco free practice translates directly into the hiring process.

For prospective new hires at both organizations, anyone who tests positive for nicotine will not be eligible for employment. In addition to asking questions surrounding tobacco use, nicotine testing is now an integral part of the pre-employment drug screening process.

“If they indicate that they have used tobacco products in the last 90 days prior to their application, they will not be able to proceed any further with the online application process. If an application tests positive, they will be eligible to reapply 12 months after testing positive for nicotine, during which time they must remain tobacco free,” explained Jennifer Morris, Pulmonary Educator at Sacred Heart Hospital.

Like Baptist, Sacred Heart Hospital’s decision was spurred by alarming statistics, included in the 2014 Surgeon General’s report, specifically showing that tobacco use not only puts individuals at a risk for developing Type II Diabetes, but also is now being confirmed as a cause.

“In the past we had always been told that it can contribute to this. Now to have them say it causes diabetes—that is huge,” Morris said.

This latest Surgeon General’s report marks 50 years since the release of the first report. In addition to highlighting increased risks to smokers themselves, the report states that 2.5 million nonsmokers have died from secondhand smoke since 1964.

“With that being known, we know that any cigarette exposure is harmful and can cause long term damage to the body. There is no safe level of exposure and there is no safe cigarette,” Morris said.

Not only do the statistics remain alarming on a national scale, but Morris notes the startling statistics in our own Escambia County, adding up to 23 percent of our county’s population using tobacco products, a number that is higher than the Florida average of 17 percent.

“We have higher numbers of people with lung cancers, heart disease and stroke,” she said. “All of these are and can be related to smoking.”

“Our doctors and employees see first-hand the effects of tobacco use and the damage it does to people’s health. We see the lives lost to cancer and heart disease, and the pain it brings to families. We also see the high costs associated with tobacco use to the health care system and area businesses,” she said.

As one of two of the largest area employers (the other being partner, Baptist Health Care), the hope is to make a monumental dent in decreasing these numbers and lowering the percentage, beginning with employees.

Both organizations are using a combination of new policy implementation and ongoing cessation support to make positive strides in controlling and decreasing tobacco use.

Cessation Support
Both Baptist and Sacred Heart have seen the long-lasting benefits and positive effects of cessation supports offered to employees and patients.

Baptist has offered cessation classes to their employees to take advantage of and has seen the number of users drop.

“We have seen a significant decrease in use among our existing team members,” said Meghan McCarthy, MBA, MBH, Healthy Lives Director, Baptist Health Care.

As an added incentive for employees free of all nicotine use, an insurance premium credit is given.

“We frequently think of chronic diseases like lung cancer in regards to the risks of nicotine use, but maintaining a nicotine free status provides for the best outcomes of other health situations,” McCarthy said.

“Nicotine use also negatively impacts recovery time and infection rates. For example, if you were to need surgery for a broken arm, being at a good baseline health will increase the likelihood of a speedy and full recovery in addition to reducing the costs associated with complications,” she explained.

Meanwhile, Sacred Heart Hospital has been providing Tobacco Cessation Classes since 1997. In addition to offering classes 10 times a year, they provide one-on-one personalized assistance as needed.

“We are passionate about helping anyone who wants to quit smoking achieve their goal,” Morris said. “Employees take advantage of our classes as well as our patients. We are always available to anyone ready to quit tobacco. Our classes are free, and we are able to provide those who attend with free nicotine replacement.”

For employees like Scott Wilson, a Performance Improvement Analyst in Sacred Heart’s Trauma Services Department, the smoking cessation classes offered him a roadmap and support to quit smoking—one he never knew he needed.

Wilson, who has been employed at Sacred Heart Hospital for two years, was a smoker for two decades before making the decision to finally quit. Several items prompted Wilson’s decision.

“My family was number one,” Wilson said. “I have two small children. And the cost of cigarettes was so much. We were spending a lot of money. And my health. It was just time.

Over the years, Wilson had tried the patch, as well as prescription drugs such as, Wellbutirn and Chantix. He had tried gum, lozenges and even attempted going “cold turkey.”

Wilson’s officially quit date was in February of 2013, and his wife Jennifer’s just a month prior. Not only does he cite the class as the way to support his will to quit, he found it highly flexible, and personalized.

“This is the only class I could find that had evening classes, so not to interrupt with my work schedule, which was important to me. It was one of the reasons I never took it during my time in the military— they were always in the middle of the day.”

In addition to the class offering a flexible way of gaining access to a wealth of resources and support, Sacred Heart’s cessation program allowed Wilson to learn from trial and errors, and he was able to arrive at a hybrid means of quitting.

“I always thought you could just stick with one therapy. I learned you could combine them and that’s what helped me out,” he said.

About two weeks following Wilson’s quit date, he could already tell a resounding difference.

“The immediate changes were the most dramatic. Like just being able to smell things. I never realized how bad it smelled until I wasn’t smoking anymore.”

Following the end of the classes, Wilson was able to follow up with his mentor and continue to receive personalized attention, encouragement, support and guidance in weaning off his nicotine patch.

In the long term, he cites blood pressure improvements, and actually being able to lose weight. On top of that, there has been a financial impact. Although Wilson and his wife considered themselves light smokers, they are saving $200 a month having kicked the addiction and receiving a cost-break on insurance.

“Insurance costs keep going up no matter where you are and being a smoker makes it up go even further,” he said.

Not only do the programs provide a cost-savings for smokers, but for employers.

“As health insurance rates and costs continue to rise for employers, I suspect this will be something they will evaluate,” Stone said.

Although Baptist Health Care and Sacred Heart are only two names in the health care industry, it’s to be expected that there will be other employers across various industries will follow suit promoting similar programs and policies, not simply for their own benefit, but ultimately for the greater good of their employees and surrounding communities in general.

“Tobacco use and abuse is a leading cause of preventable death in the United States,” Morris said. “We hope that other hospitals all move to help our community become a healthier community.”

For more information on Baptist’s “Healthy Lives” initiative visit, ebaptisthealthcare.org/HealthyLives
For more information on Sacred Heart’s Smoking Cessation Program, visit sacred-heart.org/smokingcessation