It’s OK to Not Be Ready to Quit

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“What are your thoughts on quitting at this time?” is a question I’ve asked perhaps more than any other since beginning work within the tobacco reduction field.

Tobacco Treatment Specialists (TTS) are trained to screen people who use(d) some form of commercial tobacco to determine their readiness to quit and interest in working within a tobacco reduction program. Within the clinics and other organizations that house these programs throughout MIchigan, additional staff are also trained to screen and refer individuals interested in reducing their tobacco use to the TTS. If someone is not ready, the conversation is paused and put off until a follow up screening can occur. If the individual indicates readiness to quit, or interest in working with a tobacco treatment professional, they are referred on to develop their own quit plan.

In a perfect world, readiness to quit would always strengthen and lead to a successful cessation of commercial tobacco use. Individuals would overcome cravings and urges to smoke without challenges to their motivation, and they would never have to deal with the question of “am I truly ready to quit?” In reality, tobacco cessation is often a non-linear process where motivation to quit increases and decreases depending on the day, hour, and even minute. It’s not uncommon for people to be ready to quit one day, and never want to even think about quitting the next. In a society that still struggles with stigmatizing those who use commercial tobacco products, not being ready to quit can feel embarrassing. This feeling of embarrassment can often lead to people feeling pressured to quit, whether they truly are or not.

Here are three reasons why it’s OK to not be ready to quit your commercial tobacco use.

1. Quitting is Challenging 

Quitting smoking is challenging two reasons:

  1. Nicotine withdrawal and
  2. You have to adjust your daily routine to not include smoking 

Neither is an easy feat and can be intimidating for anyone looking to reduce, whether they have previous quit experience or not. Determining where to start and how to counter cravings or urges to smoke can alter confidence in one’s ability to quit. Though both can be dealt with successfully in the short and long term, it’s okay if the challenge seems daunting at the time being.

2. Only You Can Determine How to Quit

The most important part in developing any quit plan is to know that only YOU can determine how you are going to quit. No outside person whether it be a TTS, a doctor, a case worker, or a loved one can tell you the best way for you to quit. Whether they have successful quitting experience or not, we know that there is no guaranteed way for all people to quit, and that anyone who uses commercial tobacco will have to plan ways to cope with their specific challenges.

3. It’s NEVER Too Late to Quit

Whether you’ve quit before or not. Whether you’re 22 or 72. Whether you smoke half of a pack per day or two packs per day. Whether your entire family smokes, or no one in your family smokes. The best thing about trying to quit commercial tobacco products is that each new day is always another opportunity to quit or to think about quitting. 

Many question what the point of quitting late in life is, especially if they feel they won’t enjoy the long term benefits of quitting as long as someone who quit in their 20s/30s/40s/50s would. But there are short term benefits that one can experience almost immediately and throughout the first year of being quit including:

How Can I Build Readiness to Quit?

Even if one is not currently ready to quit, you might still know that you would like to quit someday. But how does one build readiness to quit? There are various ways to build both motivation and readiness to quit including:

  • Explore new resources – look into options previously unused. Quit medications, Quitlines, online resources, support groups, or tobacco treatment programs can all be a great place to start. 
  • Consider the benefits that you will experience – both short and long term, write down all the positives you might experience when quitting. 
  • AND the benefits that are most important to you – highlight the benefits that are most important to you. These will build motivation to and interest in quitting more than a general list will. 
  • Find support or program options – whether in support groups, healthcare settings, or amongst friends and other loved ones, think about where you will find support and who you can count on. 
  • Review what worked for you, what might work for you, and what you think won’t work for you when quitting – if you have experience in quitting, you might have concerns about your ability to quit successfully long term. But previous quitting experience can be helpful in determining what has previously worked and what hasn’t, which sets you up at a great starting place. Make a list of what’s been helpful previously in craving management, and other options that may be helpful to explore this time. 
  • Try a practice quit day – pick one day, or even a half of a day, and try to go without tobacco. This will give you a better idea of what you might need to be prepared for and allow confidence to build in small successes.

Quitting commercial tobacco use can be intimidating, and though many people who use tobacco products want to quit, many are unsure of whether they’re ready or not. It’s not uncommon for people to feel pressured into quitting, whether it be by family, friends, health care providers, or even society at large. But it is okay to not be ready to quit commercial tobacco, it’s even okay to be unsure of whether you’ll ever be ready to quit. Just know that when you are ready, or if you think you might be ready, there are resources and support options available to help make it happen.

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Think you might be ready to quit or just want to know more about options? 
Contact our team for more information:

Caitlyn Clock
Tobacco Treatment Coordinator
cclock@miunified.org
(313) 316-7561

6 Tips for Tobacco Reduction During the Holidays

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As another holiday season approaches, it’s important to take time to consider how this time of year can impact your tobacco reduction goals. For many, this time of year can be incredibly motivating when it comes to commercial tobacco reduction due to weather changes, time spent with friends and family, and the feeling of a “fresh start” as we ring in a new year. However, like any holiday, a variety of emotions are in play including joy, love, stress, sadness, loneliness, nostalgia, and more. These feelings can often be exacerbated by established traditions and the media putting additional pressure on us to have the “perfect holiday”. 

We know when it comes to smoking cessation that emotions can play a major role in both successes and challenges faced. We also know that having a plan and preparing for challenges when reducing can help people feel more ready to stick to their reduction goals. But what are some ways you can prepare for the holiday when reducing your use?

Tips for Tobacco Reduction and the Holidays

  1. Get enough rest. Exhaustion will only leave you feeling more stressed which may increase the urge to smoke. Do your best to make sure you are getting enough sleep at night or schedule out times to have a nap during the day when needed. This will leave you feeling refreshed and ready to participate in events and gatherings.

  2. Set boundaries – it’s okay to say no! To extra visits, events, financial commitments, or other stressors. The holidays can be a nostalgic time for many of us, and that can often lead to pressure to make sure things are a certain way or are exactly the same as previous years. But sometimes this can lead to over-exertion and increased stress. Sit down with your loved ones to discuss plans and responsibilities and suggest changes that might need to be made ahead of time. Making sure everyone is on the same page can go a long way in preventing unexpected stressors.

  3. Have a replacement method on hand. Cravings are tough, and sometimes can occur at unexpected moments. Plan to have something on hand like a snack, a fidget toy or stress ball, a puzzle book, gum, or anything else that has been helpful in coping with cravings. Make sure you always know where it is so you can easily access it when you are dealing with a challenging moment. 

  4. Stay hydrated. Staying hydrated can help improve your mood and leave you feeling more energetic, especially when activities and events are keeping you busy. Additionally, a glass of water can be a great way to cope with cravings without picking up tobacco.

  5. Don’t beat yourself up IF things don’t go your way. Like any other major event in our lives, the holidays are prone to not having everything go exactly as planned. This is also true for plans surrounding reduction and cessation efforts. While it is important to plan to help yourself succeed in your goals, it’s equally important to extend yourself grace IF things don’t turn out the way you planned. Remember: small slip ups do not have to impact or prevent your long term success. Give yourself the chance to get back on track with your goals rather talking yourself into abandoning them.

  6. Take time to enjoy the season. Regardless of your plans or traditions, the end of the year can be a great time to reconnect with loved ones and find joy. Both of which can support your goals with reduction. Take time to enjoy everything you love about this time of year OR find opportunities to make new happy memories to look back on next year. Remember, regardless of where you are with your reduction plans: you deserve the chance to relax and enjoy time with the ones you love.

Tobacco Reduction resources and supports 

When developing a quit or reduction plan, we often discuss the importance of having support whether it comes from a TTS, a friend, a coworker, or anyone else in your life. But the holidays can impact availability and your access to them. Because of this, it’s good to have additional resources prepared to fall back on when you’re facing a challenging moment. Such resources might include:

  1. A Quitline service: the Michigan Quitlink has available services for support including online and phone-based support and available 24/7.

  2. Check out the Quit Plan Builder at Smokefree.gov for an easy option to develop or alter your quit or reduction plan.

  3. Phone applications can offer assistance in tracking your days quit and motivation reminders, as well as tips and other resources when facing tough moments.

  4. Have a designated friend/family member that you can reach out to when you’re in need of support. Having this set up in advance allows you to know who is going to be available for a check in and when. 

The holidays can be a joyful yet tumultuous time for many. New or additional challenges or stressors DO NOT have to prevent you in reaching your goals. Take time now to make a plan so you can feel prepared and in control of your reduction efforts this season. 

For more tips you can check out our video for navigating reducing your tobacco use during the holidays and articles like this one.

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Have any questions or are looking to reduce commercial tobacco use?
Reach out to our tobacco reduction team:

Caitlyn Clock
Tobacco Treatment Coordinator
cclock@miunified.org
313-316-7561

Changes to Celebrate When Quitting Tobacco

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Clients involved in our tobacco use reduction program generally have the same goal– becoming tobacco free. When you quit tobacco, your body and brain experience physical changes as they adapt to the lack of nicotine and tobacco. Quitting tobacco also involves starting new habits and changing your overall lifestyle. The process of quitting tobacco can feel overwhelming and frustrating, especially when you haven’t achieved your end goal yet.

However, it is important to give yourself credit for everything you’ve achieved so far. Even if you are still in the process of becoming tobacco free, your health has likely benefited from the changes in your routine and mindset. Recognizing and giving yourself credit for these accomplishments is important and can help you stay motivated in your journey. So what changes can you expect to see when quitting tobacco?

You’re developing healthier coping skills

Smoking can become an automatic response to stress, anger, and other unpleasant emotions. Between tobacco’s addictive nature and the way it easily becomes a habit, it is not uncommon for smoking to become an unhealthy coping mechanism. When quitting tobacco, it is important to identify situations where you are using tobacco as a coping skill. The next step is replacing the habit of smoking with other healthier behaviors. Discovering and implementing healthy coping skills is a huge victory when quitting tobacco. Not only can these skills help with reducing smoking, but they also help with stress management and living an overall healthier lifestyle.

Image from Pexels

You can go longer without smoking your first cigarette

One of the ways nicotine dependence is measured is by how soon after waking up you have your first cigarette. Since you are not using tobacco while you sleep, your body tends to go into withdrawal overnight. This is the reason people tend to crave a cigarette as soon as they wake up. Being able to go longer without your first cigarette of the day is a sign that you are becoming less dependent on nicotine. Even being able to go a few minutes longer without reaching for a cigarette is worth celebrating.

You know when to walk away from triggering situations

Learning to accept and cope with difficult situations is important, but there is also value in knowing when to walk away. Quitting tobacco might involve saying no to or leaving situations where you’ll have to urge to smoke. For example, the smell or sight of a cigarette is a common trigger. Learning to remove yourself from these situations can not only help you with tobacco cessation, but it can also teach you how to better manage situations that could damage your general health. The way you manage your triggers may also change over time. You might initially need to walk away from a situation, but with time you might learn how to better manage said trigger.

You can prevent slips from becoming relapses

When discussing quitting tobacco, a ‘slip’ refers to a singular incident of smoking whereas a ‘relapse’ refers to going back to your previous habits . Slips are very common, but they don’t always have to lead to relapsing. Instead of beating yourself up over a slip, focus on what you can learn from it. Reflecting on your slip– where were you, what were you doing, and how were you feeling– can help you better understand your triggers along with what is and isn’t a helpful strategy to manage them.

You’re able to accept yourself and your life as they are

Accepting what you can and can not control is key to making lifestyle changes, such as quitting tobacco. Triggering situations may be out of your control, and life may not go as expected even when we feel in control. Radical acceptance is a term that refers to accepting yourself and your life as they are rather than dwelling on what could be different. Learning acceptance takes practice, but feeling unable to accept reality can increase the pain in distressing situations. On the other hand, radical acceptance also involves giving yourself credit and accepting positive situations. It may be difficult to accept that you haven’t been able to completely quit tobacco, but there is also value in accepting the progress that you’ve made.

Image from Pexels

Becoming tobacco free can feel overwhelming as the process takes time and patience. Breaking it down into smaller steps and learning to recognize the small victories can make cessation feel more achievable. Realizing what you’re gaining from quitting smoking can help you stay motivated. If you’re feeling stuck in your cessation efforts, UNIFIED’s tobacco reduction program can help you create a plan to keep moving forward.

If you would like to learn more about tobacco reduction and cessation, please contact our team:

Caitlyn Clock (313)-316-7561

Exploring the Environmental Impact of the Tobacco Industry

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Bird feeding a cigarette butt to its chick. Photo: Karen Mason / Audubon

What do you think is the most littered item: plastic bottles? Possibly straws?

The number one most littered item is actually cigarette butts. Contrary to popular belief, cigarette filters are not biodegradable, and as the cellulose acetate they contain breaks down, tiny pieces of plastic are spread into the environment. Microplastics have been found in every stage of the food chain, our drinking water, even the air we breathe. In fact, it is estimated that, on average, we could be eating as much as a credit card worth of plastic each week.1 How many cigarette butts do you think you’ve eaten?

The Office / Crooked Marque

Cigarette butt pollution is a very visible indicator of the damage the tobacco industry has on the environment, and it is only a small part of a large, global problem. The World Health Organization released a report this year on the environmental damage the tobacco industry causes through deforestation, depletion of resources, chemical waste, and carbon emissions. This report, along with other recent publications, illustrate the ways the tobacco industry poses a serious threat to the health of our planet through the manner in which commercial tobacco products are grown, manufactured, and discarded.2

A Growing Problem

The topic of climate change seems to get hotter every year, much like the average temperature of the planet. As fossil fuel use adds excessive greenhouse gases into the atmosphere and deforestation removes the natural processes that offset these gases, the ability of the earth to release heat into space diminishes.3 The tobacco industry is a major contributor to deforestation. Forests are clear cut to create farmable land for commercial tobacco production. Combined with the trees used in the curing process, a total of approximately 200,000 hectares of forest is lost each year. For context, that would be a forest the size of Yellowstone National Park leveled in less than 5 years. It is estimated that 5% of total annual deforestation is related to the tobacco industry.

The soil in which tobacco is grown can become unsuitable for other crops, which compounds issues of food scarcity in the lower income countries where these farms are mainly located. Nicotine exposure is difficult for farmers to avoid, and studies show that people working on these farms are exposed to the equivalent of 50 cigarettes per day. Symptoms of “green leaf sickness”, a common name for nicotine poisoning, are prevalent. Tragically, many of those who work on these farms are children.4

Young child binding tobacco leaves by hand. Photo: Marcus Bleasdale/Human Rights Watch Quote: British American Tobacco / Report

As mentioned above, the curing process requires significant deforestation. These trees are burned, releasing chemicals into the atmosphere. Once cured, the tobacco is transported to manufacturing facilities then on to distribution centers and consumers, generating significant carbon emissions. Chemical waste made during the manufacturing process often makes its way into water systems where it disrupts ecosystems. E-cigarette manufacturing is more difficult to describe in terms of environmental impact due to limited data, but it is speculated that these products require even more environmentally taxing processes.5

Only You Can Prevent Dumpster Fires

E-cigarette components present a new, unique concern for the planet compared to the aforementioned cigarette butt. Plastic, metals, nicotine, filler compounds, flavor additives, batteries, and the other materials that comprise the 460+ brands6 of e-cigarettes are improperly discarded with increasing frequency. Littered e-cigarettes are a complicated problem, but disposing of these devices responsibly is also difficult. Liquid nicotine is legally classified as a hazardous waste, and many types of e-cigarette must be disposed of at specialized facilities. Due to lack of information, consumers often throw e-cigarettes directly into their regular trash or recycling. There are increasing incidents of garbage truck and dumpster fires related to the lithium ion batteries found in e-cigarettes.

Smokey the Bear / GIPHY
Fraction of environmental impact of tobacco industry by stage. 7

The above graph published in Environmental Science & Technology shows that tobacco farming (medium blue), curing (yellow), and manufacturing (light blue) have the most impact on the environment. Tobacco companies attempt to shift the emphasis on the consumer when it comes to environmental responsibility. They use greenwashing strategies to improve their appearance and send an “only you” message concerning the prevention of tobacco waste.

Greenwashing refers to an entity, namely a company, cultivating an image of eco-friendliness to distract from their harmful environmental impact. Tobacco companies publicly donate to events such as clean ups and run campaigns on the importance of proper cigarette butt disposal. Additional emphasis is placed on “green” business operations, such as the use of electric vehicles or reduction in office waste. As the graph clearly shows, however, the majority of the environmental impact occurs far from corporate offices and before the consumer is sold the product. In the big picture, clean ups and donations are performative marketing.

Natural American Spirit greenwashing ad that ran in magazines such as Vogue and Rolling Stone promoting “cleanup challenges” for Earth Day. Photo: Trinkets and Trash

The More You Know

The World Health Organization, among others, is working to bring to light the damage that the tobacco industry is causing and the strategies these companies use to shift responsibility onto the consumer. Governments worldwide are beginning to put more pressure on these companies to take responsibility and to move toward more sustainable practices. In the meantime, consumers can educate themselves on how to dispose of their waste. The FDA provides information on how to properly dispose of e-cigarettes. There is a county directory of Michigan recycling and hazardous waste contacts that can also be a good place to start.

The relationship between the environment and the tobacco industry is a complex, evolving subject. For further reading, check out the 2022 WHO publication Tobacco: Poisoning Our Planet. The Truth Initiative is also a reliable resource for information on topics like e-cigarette waste. Tobacco Tactics has well researched articles on subjects such as greenwashing. Finally, the infographic below provides a visual summary of the facts discussed above and other interesting, eye-opening pieces of data.

CDC

If you would like to learn more about tobacco reduction and cessation, please contact our team:

Melissa Small – Ypsilanti/Jackson Tobacco Treatment Specialist

(734) 329-9223

Monica Allen – Detroit Tobacco Treatment Specialist

(313) 949-2938

References:

  1. Kala Senathirajah, Simon Attwood, Geetika Bhagwat, Maddison Carbery, Scott Wilson, Thava Palanisami, Estimation of the mass of microplastics ingested – A pivotal first step towards human health risk assessment, Journal of Hazardous Materials, Volume 404, Part B, 2021,124004, ISSN 0304-3894, https://doi.org/10.1016/j.jhazmat.2020.124004. (https://www.sciencedirect.com/science/article/pii/S0304389420319944)
  2. Tobacco: poisoning our planet, World Health Organization, 2022, ISBN 978-92-4-005128-7
  3. Dean, Annika, Deforestation and climate change, August 21, 2019, https://www.climatecouncil.org.au/deforestation/#:~:text=Burning%20fossil%20fuels%2C%20in%20combination,carbon%20sinks%20such%20as%20forests.
  4. Larson, Nina, Big tobacco’s environmental impact is ‘devastating’: WHO, May 31, 2022, https://phys.org/news/2022-05-big-tobacco-environmental-impact-devastating.html
  5. Tobacco and the Environment, Tobacco Tactics, updated 30 May 2022, accessed 01 August 2022. https://tobaccotactics.org/wiki/tobacco-and-the-environment/
  6. NIDA. 2020, January 8. Vaping Devices (Electronic Cigarettes) DrugFacts. Retrieved from https://nida.nih.gov/publications/drugfacts/vaping-devices-electronic-cigarettes on 2022, August 2
  7. Cigarette Smoking: An Assessment of Tobacco’s Global Environmental Footprint Across Its Entire Supply Chain, Maria Zafeiridou, Nicholas S Hopkinson, and Nikolaos Voulvoulis, Environmental Science & Technology 2018 52 (15), 8087-8094, DOI: 10.1021/acs.est.8b01533

5 Tips for Setting Boundaries While Quitting

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In my personal and professional life, it is not uncommon to hear about tension between those trying to quit tobacco and others in their lives. Friends and family can serve as a great support system, but they can also unintentionally become a barrier to quitting. It can be difficult to navigate your reduction journey when those around you continue to smoke or be unsupportive. Common advice, such as ‘get new friends’ or ‘just avoid smokers’, tends falls flat for folks who have deeper relationships with people who are unable to support them on their quit journey. So how do you balance quitting tobacco while maintaining relationships with others?

Image from Pexels

Having and learning to set boundaries allows you to keep a healthy connection with friends and family. The term ‘boundary’ has become a buzz word recently, but what exactly does it mean? A boundary refers to that imaginary line between you and others; it separates your physical and emotional needs, feelings, and responsibilities from others. Boundaries exist in every aspect of our lives, whether it is needing privacy from roommates, being uncomfortable with certain sexual activities, or refusing to do certain tasks at work. Everyone has boundaries, but it takes time and practice to learn what yours are and how to express them.

Boundaries are a powerful tool for those attempting to reduce or quit tobacco. Your boundaries might look like refusing to buy cigarettes for others, being able to walk away from people who are smoking, or any other limits you have to maintain your quit. Setting boundaries is easier said than done, but with practice they are a great way to protect your needs and your relationships with others. So how do you actually use boundaries in real life?

Image from Pexels

1. Focus on what you can control

Setting boundaries allows you to express what you need from others. However, you can not control others’ behavior. When setting boundaries, it is important to focus on what you can control: yourself and your actions. Boundaries are a reflection of your own needs, values, and comfort. Though it can be difficult at first, it is up to you to learn what your boundaries are, how to communicate them to others, and how you can respond to them being crossed.

2. Set boundaries before they are crossed

Once you’ve realized the boundaries you need to set, it can be helpful to communicate them to others before they get crossed. Communicating what you need before you’re in a tough situation can allow you to express yourself with a clear mind and avoid resentment in your relationships. For example, you might consider letting friends know you’re working towards quitting and are currently uncomfortable being around others while they smoke. Communicating ahead of time can help you avoid triggering situations, whether that means your friends going outside to smoke or them knowing why you may need to walk away when they smoke.

3. Don’t assume others’ intentions

When others are unable to respect our boundaries, it is natural to feel frustrated and hurt. Boundaries exist to keep us emotionally and physically safe, and it is important to build relationships where you can respect each other’s boundaries. However, we also don’t know others’ intentions when they can’t respect our boundaries. Someone who continues to offer you cigarettes, doubt your ability to quit, or be unsupportive in other ways may be unaware of how hurtful their actions are. Their behavior is more likely a reflection of their beliefs and values; they may view smoking as a way to connect or might not understand how important quitting is. This does not excuse their actions, but being able to take a step back and avoid assumptions can help us avoid resentment.

4. Boundaries help save relationships

At first, having boundaries can seem like a wall between you and others. Setting boundaries can be uncomfortable and may change the dynamics of your personal relationships. However, everyone has personal boundaries and expressing them can actually strengthen relationships. Having relationships where you both can comfortably express what you need from one another can help create safety and respect between each other.

5. Learn how to respond when boundaries are crossed

After setting a boundary, it is your responsibility to stand firm in what you need and learn how to set consequences when others can’t respect that. Boundaries are an opportunity to teach others how to treat you. If someone continues to cross your boundaries, it is time to determine how to distance yourself from harmful situations. This might look like walking away from or refusing to be in situations where your boundaries to be crossed, but it can also be a chance to create spaces where your boundaries will be honored.

If you would like to learn more about tobacco reduction and cessation, please contact our team:

Melissa Small – Ypsilanti/Jackson Tobacco Treatment Specialist

(734) 329-9223

Monica Allen – Detroit Tobacco Treatment Specialist

(313) 949-2938

The True “Cost” of Tobacco

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At least two things about cigarettes are popularly understood: 1. They are extremely harmful to your health. 2. They are expensive. But “expensive” is a subjective term. What is the personal cost of smoking? And what is the more broad economic impact of the tobacco industry? While there is no simple answer to these questions, there is much to explore regarding the financial, medical, and environmental burden of commercial tobacco use.

Arrested Development/Giphy

Individual Cost, Communal Bill

The average cost for a pack of cigarettes in Michigan today is $8.27.1 To put that into perspective, the average Michigan smoker of median income would spend roughly 7% of their earnings on cigarettes.2 3 There are other direct and indirect costs of tobacco use. Smokers can pay as much as 50% higher on health insurance premiums4, and copays for medications and frequent office or hospital visits add up quickly. There is also opportunity cost, or the loss of potential gains from using funds for tobacco and tobacco related illness rather than investing into other aspects of life. One study estimated the total lifetime cost of smoking for an individual in Michigan was $2,193,645.5 Smoking, and the use of other tobacco products, is a heavy expense for the individual, but it also places a heavy financial burden on society.

Humphrey Yang/Tik Tok

Direct and Indirect Cost

The CDC reported that the U.S. spends $226.7 billion in one year on public and private health care costs related to tobacco use. Over half of this figure is tax funded. For perspective, that averages to each household paying $1,223 in taxes yearly just for tobacco related health care expenses. The CDC report states there is an additional $6.99 billion in health care costs related to secondhand smoke.6 Tobacco related illnesses also demand medical resources, and delays in care can increase the severity – and cost of treating – other patients.

Unsplash/Brian Yurasits

Exploring the Environmental Cost

The treatment of tobacco related illness requires significant energy use and creates a massive amount of medical waste. This, along with the environmental damage related to production and consumption of tobacco products, contributes to a growing economic and existential problem. The White House recently released a report which claimed that by 2100 extreme weather events related to climate change could cost the country $2 trillion each year.7  It is difficult to estimate the economic impact of something as nebulous as the tobacco industry, which requires significant deforestation, water consumption, and carbon emissions to operate. One study found that the cost to simply address pollution caused by cigarette butts in the 30 largest U.S. cities was $264.5 million each year.8 Concern has been raised about even greater danger posed by electronic cigarette pollution.

Parks and Rec/Tenor

Liability, Lies, Limits

The cost to address these problems must be borne by someone, and the tobacco industry is spending a fortune to deflect that responsibility onto the individual, with society ultimately left to pick up the bill. It’s a tough battle for anti-tobacco activists. In 2020, tobacco companies spent $28.2 million lobbying Congress alone.6 Accountability is a hard sell when tobacco companies are able to legally pay politicians, spend $23 million a day on marketing, and sponsor their own “research”. Perhaps, though, the fact that tobacco companies need to spend so much to survive is a positive sign. As our society continues to gain better understanding of personal wellbeing, the broad implications of public health, and the danger of climate change, the facts will be too loud to hush. The simple conclusion is that the true cost of tobacco will always be too much.

Further reading:

  • This Smokefree.gov calculator shows how much money is saved over time after quitting cigarettes.
  • ASH (Action on Smoke and Health) provides a wealth of information on the effects of the tobacco industry and what legal/policy measures can be taken to eventually end tobacco related deaths.
  • Tobacco Free Funds provides information on funds that invest in tobacco manufacturers or entertainment agencies that promote tobacco use.

If you would like to learn more about tobacco reduction and cessation, please contact our team:

Melissa Small – Ypsilanti/Jackson Tobacco Treatment Specialist

(734) 329-9223

Monica Allen – Detroit Tobacco Treatment Specialist

(313) 949-2938

References

1: “Cigarette Prices by State 2022” World Population Review. Retrieved from: https://worldpopulationreview.com/state-rankings/cigarette-prices-by-state
2 & 3: Calculated using (average cost x average consumption) divided by median income.
2: “US Households Number of Cigarettes Smoked on an Average Day 2020” Statista. July 2021 Retrieved from: https://www.statista.com/statistics/275993/us-households-number-of-cigarettes-smoked-on-an-average-day/
3: “Median Individual Income in Michigan” Data Commons. Retrieved from:
https://datacommons.org/place/geoId/26?utm_medium=explore&mprop=income&popt=Person&cpv=age%2CYears15Onwards&hl=en
4: “Marketplace Premiums Rise Faster For Tobacco Users Because Of Subsidy Design.” HealthAffairs. September 2020. Retrieved from: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2020.00015
5: “The Financial Cost of Smoking by State” WalletHub. January 2022. Retrieved from: https://wallethub.com/edu/the-financial-cost-of-smoking-by-state/9520
6: “The Toll of Tobacco in the United States” Tobacco Free Kids. November 2021. Retrieved from: https://www.tobaccofreekids.org/problem/toll-us
7: “The Future Cost of Climate Inaction 2 Trillion a Year Says the Government” NPR. May 2022. Retrieved from: https://www.npr.org/2022/04/07/1091258821/the-future-cost-of-climate-inaction-2-trillion-a-year-says-the-government
8: Schneider, J. E., Scheibling, C. M., Peterson, N. A., Granados, P. S., Fulton, L., & Novotny, T. E. (2020). “Online Simulation Model to Estimate the Total Costs of Tobacco Product Waste in Large U.S. Cities.” International journal of environmental research and public health, 17(13), 4705. https://doi.org/10.3390/ijerph17134705

FDA Proposed Menthol Ban

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In April of 2022, the U.S. Food and Drug Administration proposed a ban on the manufacturing and sale of menthol cigarettes and cigars. The FDA hopes this ban will “help prevent children from becoming the next generation of smokers and help adult smokers quit” along with reducing health disparities. Previous legislation has banned flavors, with the exclusion of tobacco and menthol, in cigarettes and e-cigarettes. It is important to note that the ban would target those making and selling menthol cigarettes, but it would not punish those who possess menthol cigarettes. This distinction allows Big Tobacco to experience consequences without penalizing those struggling with addiction.

Menthol may be one of the most popular flavors for tobacco products, but people may not be familiar with what it actually is. A chemical naturally found in peppermint, menthol can be described as minty and cooling. This flavoring may make smoking feel less harsh and seem healthier, but menthol can actually make it easier to start smoking and make it more difficult to quit. Studies have found that those who smoke menthol are less likely to quit when compared to those who smoke non-menthols.

Kool Your Throat

Not only are menthol cigarettes designed to be more addictive, but they have also historically targeted African Americans through their marketing tactics. Mentholated brands, such as KOOL and Newport, have been advertised in Black publications and other media. Big tobacco also has a history of sponsoring Black events and organizations. For example, Philip Morris (owner of Marlboro, Virginia Slims, and other brands) has sponsored the National Association for the Advancement of Colored People, the Urban League, and the United Negro College Fund. There are countless examples of Big Tobacco targeting African Americans and other minorities. Bans and regulations surrounding tobacco may prevent future generations from being impacted by the tobacco industry’s marketing, but decades of targeting have already damaged many individuals and communities.

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By banning menthol, the FDA can work towards making tobacco less appealing and accessible. Not only could it prevent younger generations from using tobacco, but banning menthol could also act as an incentive to help those who currently smoke quit. As tobacco becomes more regulated and restricted, the tobacco industry loses its ability to influence more people to smoke. For more information on the proposed ban, you can check out the FDA’s official Press Announcement.

If you’re interested in learning more about tobacco reduction and cessation, please contact our team:

Monica Allen, Detroit Tobacco Treatment Specialist

(313)-949-2938

Melissa Small, Ypsilanti/Jackson Tobacco Treatment Specialist

(734)-329-9223

Unpacking Tobacco Use in the LGBT+ Community

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The decline of tobacco consumption throughout the previous decades is worth celebrating. Increased tobacco cessation programs, awareness surrounding the health effects of tobacco, and legislation to limit consumption have worked together to create an environment where more people can either quit tobacco or not start smoking at all. However, this decline has not affected all people and communities equally. Rates of tobacco use among the LGBT+ community have remained disproportionately higher than in the general population.

National data from 2016 shows that the rate of tobacco use among lesbian, gay, and bisexual adults is 20.5% compared to 15.3% in heterosexual adults. There are even larger disparities for transgender adults as 32.6% of transgender adults currently use tobacco compared to 23.6% of cisgender adults. For transgender youth, the rate of smoking cigarettes is nearly 4x compared to cisgender youth. These disproportionately high rates remain consistent among all tobacco products, and more information on how tobacco use compares within the LGBT+ community can be found here.

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Big Tobacco and the LGBT+ Community

When we discuss differing rates of tobacco use, it is important to examine why these disparities exist. Big tobacco has strategically marketed to the LGBT+ community through LGBT+ publications and events. In particular, R. J. Reynolds (the parent company of Newport, Camel, Pall Mall, and Doral) launched Project SCUM (Subculture Urban Marketing) in the 1990’s. This campaign targeted the LGBT+ and homeless populations in hopes of increasing their tobacco use. R.J. Reynolds is not the only company to market cigarettes as a normal and exciting part of LGBT+ life. Other companies within big tobacco have exploited the community through targeted advertisements, sponsoring pride events, and funding LGBT+ and HIV/AIDS organizations. These marketing tactics may no longer exist today, but their impact on the health of the community remains.

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How Health Inequities Impact Smoking Cessation

Beyond the history of what led more folks within the LGBT+ community to start using tobacco, there are also barriers that make quitting more difficult as well. LGBT+ individuals are more likely to experience discrimination or have negative experiences with healthcare providers. Providers may be ignorant or have preconceived notions regarding LGBT+ health issues, which can lead to inadequate care or a lack of care altogether. One study found that 18% of LGBT+ individuals reported avoiding seeking out healthcare due to fears of discrimination. When discrimination around one’s identity is combined with the stigma surrounding tobacco use, it can be challenging to find a provider who is empathetic and committed to addressing everyone’s unique needs.

LGBT+ folks are also more likely to experience financial barriers when seeking out healthcare. The Affordable Care Act and legalization of same-sex marriage have helped to provide health insurance to the LGBT+ community, but healthcare still remains unaffordable for many. Though data on LGBT+ health is limited, it is suggested that LGB adults are more likely to avoid necessary care due to cost. Transgender adults experience the same inequity when it comes to the cost of care, and they are also less likely to have insurance compared to cisgender adults. These inequities can make it more difficult for LGBT+ folks to receive nicotine replacement therapy, counseling, and other cessation support.

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Tobacco Reduction and Cessation Resources

Learning about health disparities can be discouraging, but more people are taking the time to educate themselves on these inequities and work to change them in their personal and professional life. Southeast Michigan has various organizations that provide physical and behavioral healthcare to the LGBT+ community.

  • Here at UHHB we provide inclusive care and resources to people living with HIV in the Detroit, Ypsilanti, and Jackson areas. This includes our tobacco reduction program that offers counseling, support groups, and other resources to individuals looking to reduce their tobacco use.
  • Ruth Ellis Center in Detroit has a variety of services for LGBT+ youth and young adults, including a Health and Wellness Center with behavioral health services.
  • The Corner Health Center in Ypsilanti offers physical and behavioral health services to LGBT+ youth, including support with tobacco reduction.
  • Ozone House provides shelter and support for at-risk youth. Some of their programs include LGBT+ support groups, counseling, and substance use support.
  • LGBT Detroit supports the Detroit LGBT+ community through advocacy and education. They offer various programs to provide a safe space and increase the wellbeing of Detroit’s community.

Commit to Quit: World No Tobacco Day 2021!

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What is World No Tobacco Day?

World No Tobacco Day (WNTD) is an annual global event sponsored by the World Health Organization (WHO). Falling on May 31st, WNTD’s purpose is to inform the public on “the dangers of using tobacco, the business practices of tobacco companies, what WHO is doing to fight the tobacco epidemic, and what people around the world can do to claim their right to health and healthy living and to protect future generations”.

WNTD was initially created in 1987, with the World Health Assembly passing a resolution that would declare April 7th 1988 a “world no-smoking day”. The goal was to encourage current tobacco users to abstain from using tobacco products for a 24-hour period. In 1988, a second resolution passed naming May 31st the official date for World No Tobacco Day and making it an annual event.  

Each year, WHO chooses a different theme to accompany the day. With the first theme being “Tobacco or Health: Choose Health”. Since then, we have seen various themes focused on health, tobacco industry tactics, and ways we can fight back. This year’s theme of “Commit to Quit” comes from the renewed commitment to quit many people who currently use tobacco products have found as a result of the COVID-19 pandemic. 

WNTD 2021: “Commit to Quit”

For many people, the COVID-19 pandemic has been a new reason to quit their tobacco use, but what does that look like for people who are unsure of quitting or for people who feel the pandemic has decreased their motivation to quit? Tobacco cessation is a different process for everyone, and there is no single guaranteed path to a successful quit. Similarly, the idea of “Commit to Quit” might look different from one person to the next.

Your “Commit to Quit” might be one hour, one day, one year, or maybe forever. Your “Commit to Quit” might not be for this year’s World No Tobacco Day event, but rather a new commitment to yourself to quit one day in the future. “Commit to Quit” might mean taking the time on May 31st to simply consider reducing your tobacco use, or it might mean taking time to explore the options and resources that are available to you. 

Ways to Get Involved

There are many ways to get involved with this year’s World No Tobacco Day event, including options to meet you wherever you’re at on your quit journey. You can:

Resources 

There are many resources available online when it comes to tobacco cessation. In addition to our counseling-based tobacco treatment services at UHHB we have our tobacco blog, a monthly live stream (every second Tuesday of the month at 2:00 PM) on Facebook and Youtube (livestreams recorded and saved to both websites),  and our World No Tobacco Day video series being posted this month leading up to the big day. You can also reach out to our Tobacco team for additional information and resources.

If you’re interested in other web- or phone-based resources you can check out Smokefree.gov and smartphone applications like “SmokeFree”, “myQuitTime”, and “quitStart”.These apps and websites can be helpful in setting up a plan, tracking your days quit, building motivation, and finding distractions or other coping strategies for cravings. 

Local quitlines are another great resource to utilize to build motivation and start your own reduction plan. You might also reach out to your doctor or another trusted healthcare provider if you are interested in quit medications or discussing the benefits of quitting or reducing your tobacco use. 

Commit to Quit? Maybe!

World No Tobacco Day can be a great day to either start or continue your quit journey. Wherever you are, or whatever “Commit to Quit” looks like for you, remember that tobacco cessation looks different for everyone. Any attempt you make in reducing your use whether it be a definitive quit, smoking one less cigarette a day or week, deciding to try again after a past attempt didn’t go like you hoped, or simply reading up on available resources for tobacco cessation is a step worth celebrating. Whether you’re planning to participate in this World No Tobacco Day or it’s just another day for you, any day, regardless of whether it’s a “tobacco holiday” or not, is a good day to “Commit to Quit”.

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Want to learn more about this year’s World No Tobacco Day or just interested in tobacco reduction resources? Contact our tobacco reduction team:

Detroit

Amber Jager – (313) 316-6226

ajager@miunified.org

Ypsilanti/Jackson

Caitlyn Clock – (313) 316-7561

cclock@miunified.org

Breaking Up with Boredom

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“I’m just…bored” is something I’ve been hearing a lot lately. Whether it be from myself, clients, colleagues, or family members, it seems like everyone is struggling with increased boredom these last months. Though it has certainly been boosted by the COVID-19 pandemic, boredom is far from a new experience. This is especially true for people who are working to reduce or quit their tobacco use. 

What is boredom?

To me, boredom is one of those concepts that everyone seems to have an idea of what it is, but when we try to define it with words it’s suddenly difficult to explain. Because of this, having specific definitions can come in handy as we work to combat boredom. This month’s blog and livestream used a couple specifically:

  1. Boredom is “the state of being weary and restless through lack of interest…”
  2. “…attentional failure (i.e. being unable to successfully engage attention w/ an activity) and or perceived lack of meaning can lead to boredom…”

COVID-19 impact

“…perceived lack of meaning can lead to boredom…” is something I’ve been thinking about more often as we continue to find ways to deal with COVID-19 and public health responses. For nearly the last year, we’ve all been dealing with changes to our daily lives in one way or another due to the COVID-19 pandemic. Whether you’re staying home more, changing the ways you connect with others socially, have developed a new routine, or maybe even completely stopped having a routine, change as has been unavoidable. These changes have also had their hand in influencing the amount of boredom we face. While boredom was not created by the pandemic, the pandemic has certainly resulted in an increase in the amount of boredom one might experience daily or weekly. Additionally, it may leave many experiencing something similar to “Groundhog Day” syndrome given the lack of opportunities for new or exciting activities. Even with hopeful changes coming our way, increased boredom will likely continue for longer than we hope.

Boredom and tobacco reduction

While boredom is common and maybe in some cases welcome from time to time, too much boredom can be challenging, and this especially true for someone who is currently trying to quit or reduce their tobacco use. People often smoke when they’re bored and this is for a few different reasons including:

  1. Boredom is emotional trigger (i.e. people are used to smoking when they’re bored and therefor when they experience boredom it is the natural response to light a cigarette)
  2. Smoking gives people something to do when they’re bored
  3. They have no alternative distractions
  4. Smoking is already on their mind 

Because of this link, someone experiencing an increase in boredom in their daily life will likely also experience increased opportunities or urges to smoke. 

It’s also important to note that boredom is not only a trigger for people to smoke and can also be a result of reducing your tobacco use. Tobacco use is something that takes up a pretty decent amount of time throughout your day. On average, it takes someone 5-6 minutes to smoke a single cigarette, which opens up about an hour per day for those smoking ½ of a pack per day and two hours for those smoking a pack a day. Those who smoke cigars might be smoking anywhere between fifteen minutes to one hour per cigar depending on the type and brand. Tobacco use also takes up specific times of your day (i.e. post coffee, first thing in the morning, post meals, before/after activities, etc.). While this may not seem like much, having that much additional spare time suddenly can be challenging to deal with. This is why we try to work with our clients to find ideas for alternatives to smoking, distractions, and other ways to stay busy as a part of their quit plan as they work on their own tobacco reduction/cessation. 

Combating boredom 

This month’s blog and livestream tpoic is a result of clients dealing with boredom, and part of the hope was to offer both a deeper understanding of boredom as well as ideas to help people cope with and combat their boredom. For this I focused on two ideas: daily routines/structure and activities to keep the hands and/or mind busy.

In our very first livestream last year we discussed the idea of a “quarantine routine” and ways to help maintain structure in your daily life. Though it’s been nearly a year since I wrote the accompanying blog, the tips offered can definitely help support your daily routine – and also combat boredom by giving yourself consistency in your day to day life. It may even give you something to look forward to. 

You can also check out the ideas below for activities to incorporate into your daily or weekly routine:

  • Video games – a great way to keep your hands and mind occupied and potentially a way to connect with others if you have friends or family who also play the same games
  • Learn to knit or crochet! You don’t even need needles!
  • Games on phone such as Hearts, Sudoku, Euchre, or Words with Friends – especially if you want to keep your hands busy while watching TV/movies
  • Board games 
  • Schedule weekly calls or video chats with loved ones – or have a “virtual dinner”!
  • Journal
  • Plan “movie nights” with friends where you watch the same movie even if you can’t be together
  • Get moving! Whether you’re interested in dancing it out, yoga, walks, chair exercises, or more traditional forms of exercise this is a great way to boost your mood and keep you busy! You can find just about any type of workout on Youtube. You can also check out our HOPE program videos on our Facebook and Youtube pages.
  • Puzzles
  • Draw, color, or paint
  • Take up meditation
  • Listen to podcasts 
  • Organize your space
  • Give your home a deep clean
  • Reading – most libraries are offering virtual events and book downloads as well as other pickup services!
  • Virtual exhibits/events/etc.
  • Cooking/baking – you could even set up some sort of exchange with close friends to share the best recipes and results
  • Write letters to loved ones or your future self 
  • Make a bucket list or a list of all the things you want to do when it’s safe to
  • Try out a new hobby you’ve been interested in
  • Start an at home yoga practice

As with everything else, making massive changes all at once isn’t necessary to deal with your boredom. Planning out a couple activities/ideas (whether they’re on the above list or not!) to try the next time you find yourself experiencing boredom is a great way to start. Keep necessary supplies or even a list of your chosen ideas near your tobacco reduction supplies or somewhere easily accessible/viewable so they’re readily available the next time boredom sets in. 

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Dealing with boredom while trying to quit or interested in finding out more about Unified’s Tobacco Reduction services? Contact our tobacco reduction team:

Detroit
Amber Jager – (313) 316-6226
ajager@miunified.org

Ypsilanti/Jackson
Caitlyn Clock – (313) 316-7561
cclock@miunified.org