The winter holiday season can be a joyous and wonderful time for many, but the season is not without its challenges especially for people who are currently working on behavioral changes.
For people looking to reduce or quit their commercial tobacco use, the holiday season can create numerous challenges in sticking to a quit plan. The change of location, the change in routines, and potential for increased triggers to smoke can all result in unexpected stressors. These challenges can be intimidating and may increase the desire to smoke. While the holidays don’t automatically result in slips or relapses of tobacco use, they very much can lead as an excuse to deviate from one’s quit plan.
However, there are ways to prepare yourself to be successful in sticking to your quit plan this holiday season without it feeling like a chore or an additional worry.
Here are three tips to stick to your quit plan during the holidays:
1. Talk to your people about your quit
The holiday season often means increased time with friends and loved ones. While this can bring an immense amount of joy, those who don’t use tobacco or who aren’t currently reducing their use might not understand the support you need or why you’re working to quit. Talk to your loved ones about your decision, and your reasons for making it. Let them know what support you might need and set boundaries for the season.
2. Be prepared for stressors
Stress and the holidays pretty much go hand in hand. Prepare for these by having necessary supplies on hand. Keep supplies like quit medications, fidget toys, snacks, or other replacement items on hand whether you’re at home or traveling for easy access. Find a place where you can take a few minutes to step away from groups to ground yourself in tough moments.
Having various resources and support options are incredibly important components of developing a quit plan. Whether your support comes from a TTS, your doctor, a coworker, or a friend it’s always a good idea to have someone to speak with about your challenges and successes. But the holiday season may impact your access and availability to them. The Michigan Quitlink provides online and phone-based support available to you 24/7.
How are you managing your quit goals during the holiday season?
—
Looking for more information or resources for commercial tobacco reduction?
Slips differ from relapses in that they do not result in a return to regular use of tobacco after occurring.
When slips happen, it’s easy to feel discouraged or unsure of your path forward. But by their very definition, slips do not mean the end of your quit. Here are four tips to get back on track after you’ve had a slip:
Tip # 1: Take a pause
The most important thing to do when a slip occurs is to avoid prolonged regular use of tobacco (relapse). Pause and remove yourself from the environment where the slip happened by going to a new room, outside, or somewhere else entirely. Putting yourself in a new space can help you focus on next steps rather than continuing to smoke. Avoid being in the same space as tobacco in order to remove easy access to continued use.
Tip #2: Review your plan
Go back over your plan: what has been helpful? What hasn’t worked? What might you still need support in moving forward? Look for new options to help support your quit moving forward. Review the reasons you decided to quit. Make a list of all the benefits you have experienced so far and the ones you are looking forward to.
Tip #3: Don’t beat yourself up
When plans don’t go as you originally hoped it can be challenging or even leave you feeling like a failure. While these can be normal feelings to experience, continuing to tear yourself down over a slip can result in heightened negative emotions that are more likely to make you want to continue to smoke. You can acknowledge your slip and also realize that it doesn’t define your ability to continue with a successful quit. Remember: the slip doesn’t define your quit, but how you react to it can.
Tip #4: Get back on track right away
Avoid giving yourself permission or an excuse to continue your tobacco use. While you may think that smoking the rest of the day before renewing your quit is no big deal, falling back into old patterns and habits will lead to more challenges when getting back on track. Remind yourself that slips happen, but they don’t have to become continued or extended tobacco use.
Deciding where to start with reducing commercial tobacco use can be a challenge. But with all the available resources both in person and online it doesn’t always have to be. Here are three online resources that we recommend when thinking about quitting.
With various resources including a quit plan builder, tips and tools for tobacco reduction, and access to a live chat, Smokefree.gov is a fantastic resource for anyone who has thought about quitting their commercial tobacco use. The website also offers resources specifically for veterans, women, teens, people over 60, and a Spanish version of the website.
With online and phone-based resources, the Michigan Quitlink is a great option for those looking for support. The website hosts interactive tools including a commitment quiz, pro and con list maker, and smoking calculator for those looking to build motivation to quit. The website also has proven quit strategies and enrollment pages for an easy all-in-one resource. More information can be found on their website or by calling 1-800-QUIT-NOW.
With a good amount of video content focused on quit resources and tobacco reduction education, Unified’s Youtube page is a great option for individuals looking to build their knowledge of tobacco reduction. With topics ranging from Nicotine Replacement Therapies to Quit Kit Building to tobacco holidays like World No Tobacco Day, there is something for everyone to find good use of.
Online resources can be a great option for building motivation to quit, finding support, and discovering new strategies for coping with urges to smoke. What resources have you found that have been helpful?
—
Looking for more information or resources for commercial tobacco reduction?
“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.
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:
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.
—
Think you might be ready to quit or just want to know more about options? Contact our team for more information:
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
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.
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.
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.
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.
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.
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:
A Quitline service: the Michigan Quitlink has available services for support including online and phone-based support and available 24/7.
Check out the Quit Plan Builder at Smokefree.gov for an easy option to develop or alter your quit or reduction plan.
Phone applications can offer assistance in tracking your days quit and motivation reminders, as well as tips and other resources when facing tough moments.
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.
—
Have any questions or are looking to reduce commercial tobacco use? Reach out to our tobacco reduction team:
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:
Reaching out to a TTS or a local quitline (1-800-QUIT-NOW) to explore what quitting might look like for you
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”.
—
Want to learn more about this year’s World No Tobacco Day or just interested in tobacco reduction resources? Contact our tobacco reduction team:
“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:
“…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:
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)
Smoking gives people something to do when they’re bored
They have no alternative distractions
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
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.
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.
—
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
If you’re currently a client in Unified’s tobacco program, or if you’ve ever discussed the tobacco program with another UHHB provider, you might know that one of the services we offer through our program are quit kits. Our quit kits include a variety of items and resources including fidget toys, journals/puzzles/coloring pages, gum/candies, tea bags, outside resources like information for the Michigan Quit Line, and cough drops. However, it should be noted that this is not all a quit kit can contain, and there are multiple ways to add to your quit kit (if you’ve received one from UHHB or another service) or to build your own quit kit.
What is a quit kit?
A quit kit is a compilation of items, strategies, and resources to support someone who is looking to quit or reduce their own tobacco use. A good way to think about quit kits is that they are essentially a toolkit for quitting smoking. Oftentimes, we might think of the quit kit as something that is specifically for an individual’s quit day or only the first week or so of being quit. However, the true purpose of a quit kit is to be there to support you on your quit journey, whether that be your first day tobacco-free or your thirtieth. While this might predominantly be in times of frustration or when an individual is trying to cope with a particularly challenging craving, quit kits can also be there for moments of celebration as people begin to meet their quit goals.
Why is quitting so challenging?
Celebrating quit milestones is more important than people realize, and that’s because quitting is difficult. In our most recent Tobacco Talk Tuesday livestream, we discussed the dual nature of tobacco addiction and how that dual nature is what makes quitting so challenging for most, if not all, of those who are trying to quit smoking. The first part of this is an individual’s physical dependence on/addiction to nicotine. When someone uses tobacco products, the nicotine moves into the brain and activates a receptor that leads to the release of dopamine (a chemical that boosts your mood, motivation, and attention). This process happens within seconds and leaves people feeling great, so when the effects wear off they’re often left feeling stressed, anxious, or tense, which is the result of the body craving the next dose of nicotine. Over time, an individual will build up a tolerance to nicotine, and will therefore need to consume a greater amount in order for them to get the pleasurable effects from smoking.
The second part of this dual nature has to do with how an individual’s tobacco use has infiltrated their daily life. Someone looking to quit smoking must also address the patterns and habits that have become closely associated with their smoking. These might include: their cup of coffee in the morning, meals or snacks, driving, working out, smoke breaks at work, stress, specific places and people, as well as other various situations in which they might reach for a cigarette either before, during, or after it occurring. In order to find success in quitting, people often need to work to change these routines, which on it’s own can be challenging.
It’s because of this dual nature that we suggest a two-sided strategy and response when it comes to quitting. This is done through a combination of pharmacotherapy (nicotine replacement therapies, Chantix, or Wellbutrin) with some form of behavioral intervention (individual counseling, support groups, or quitlines).
Planning for your quit kit
Prior to starting your quit kit you might want to consider a few things:
What does a typical day look like for you with smoking?
If you’ve already created a quit plan you might have already considered and likely answered the second and third questions above. If you’ve created a quit plan, your quit kit should include items and resources that will support that plan. If you haven’t worked on creating a quit plan, tracking your smoking habits prior to creating a plan and building your kit may be beneficial. We often suggest individual’s track their habits over two days (a weekday and weekend) and write down what time they smoked, where they were/what they were doing, and how they were feeling at that time. Tracking your smoking habits will allow you to gain an understanding of what changes you might need to make in your daily life. Making sure your quit kit is ready (or at least partially ready) to go prior to your quit day is also important, and it might be useful to test out your quit kit on a practice quit day to see what was helpful and what was not.
What goes in a quit kit?
When it comes to building your own quit kit, there are very few rules about what you can add to it. The most important thing to remember is that your quit kit should support you and your own quit efforts, and therefore items or resources that will help you cope with cravings or manage specific triggers should be included. The following list of items and resources isn’t a mandatory or even complete list by any means. Rather, it’s here to give ideas and be a starting point for anyone looking to put together their own quit kit.
Maybe some of these ideas have helped you on past quit attempts, or maybe a few will help you on a future quit attempt. Regardless of the items you choose to add to your quit kit, the most important thing is that the contents of your kit are there to support your quitting efforts.
– Have additional questions about quit kits or just interested in finding out more about Unified’s Tobacco Reduction services? Contact your local Tobacco Treatment Specialist:
“Would switching to an e-cigarette be helpful?” is not an uncommon question to hear working in tobacco treatment, even with the nationwide panic over vaping occurring just under a year ago. Since their introduction into the U.S. market in 2007, e-cigarettes have been seen as a way to potentially aid in tobacco reduction/cessation by many, but most specifically the industry’s marketing teams. Additionally they’ve been marketed towards teenagers and young adults through social media and youth-oriented flavors, and as result we’ve seen major growth in use over the last five to ten years. Because of this, it continues to be important to consider the health risks and concerns that come along with e-cigarette use.
When they were initially introduced to the market, e-cigarettes looked very similar to combustible cigarettes and were a disposable product. Since then, we’ve seen major changes to both the appearance and functional capabilities of these devices – and not necessarily for the better. E-cigarettes and vapes no longer have one design, instead they now might look like pens, lighters, highlighters, USB devices, or even inhalers. In addition to modern generations being refillable and/or reusable, users can modify what is being put into their e-cigarette which leads to the ability to use marijuana and other substances with these devices.
Growth, Marketing, and Current Use
The first time I saw an e-cigarette was at least 10 years ago in a kiosk in the local mall (those who frequented Briarwood mall in the 2007-2010 might have memories of this as well), and what I remember specifically is that they were primarily being marketed as a way help adults who smoked quit cigarettes. At some point the kiosk was changed, and I didn’t really think about e-cigarettes or other ENDS products for many years. During this time, e-cigarette and vaping companies began to make major strides within the market, with focus shifting from current tobacco users looking to quit smoking to youth and young adults .
People use e-cigarettes and vapes for numerous reasons. For adults these include: to aid in quitting combustible cigarettes, to get around smoke-free laws/regulations in public spaces, and that they view them as a “safer” or “healthier” option. Youth also often believe e-cigarettes and vapes to be less harmful than combustible cigarettes (many are also unaware that these products contain nicotine) and have cited novelty and flavors as additional reasons for use.
Health Risks
Being a “safer” alternative to smoking is a commonly cited reason for using an e-cigarette, as well as being a belief many have seen used to promote these products by companies and other pro-vaping organizations and groups. Something that is seen far less in these promotions is that “safer” does not mean SAFE. There are still health risks and concerns when it comes to e-cigarette and vaping product use, with more research on long term health impacts still needed. These risks include:
Nicotine/nicotine addiction – particularly a concern for those under the age of 25 and pregnant individuals as nicotine is associated with issues with attention, learning, mood, and impulse control within the developing brain
Harmful chemicals – including cancer causing chemicals and chemicals like diacetyl (chemical flavoring) which is linked with serious lung disease
Inhalation of ultrafine particles and heavy metals such as nickel, tin, and lead
Increased likelihood for dual use and increased likelihood for using combustible tobacco products later in life
Unintentional injuries – such as explosions and/or fires caused by defective batteries or poisoning caused by swallowing, breathing, or absorbing e-cigarette liquid through the skin or eyes
Secondhand exposure to chemicals via aerosol
E-cigarette or Vaping product use Associated Lung Injury (EVALI) – has been linked with vitamin E acetate and THC containing products, and research continues to look into other causes and risks
E-cigarettes are currently regulated at the federal level by the FDA, which implemented regulations for sales and manufacturers, and some regulations to ban flavored (non-menthol) cartridges. Additionally, the FDA began recognizing ENDS as a tobacco product in 2016. In Michigan, we have two laws that currently regulate e-cigarette use and sales which:
Define “liquid nicotine” and “liquid nicotine container”, as well as establish minimum safety standards for these containers
Define e-cigarettes and vaping products separately from tobacco products
Requires these products to be stored in a locked case or behind the counter in vape and smoke shops
Prohibits sale to minors
Prohibits use/possession by minors
Like the FDA, Michigan and other states across the country have attempted flavor bans or other regulations of flavored e-liquids. Overall there have been issues with these attempts not being strong enough. Menthol and mint flavors are often not being targeted by these bans, and some brands are able to avoid them through device design, allowing for flavors popular with youth to remain on the market.
It should be noted that due to some of these efforts and restrictions at the federal and state level, there has been a shift in marketing tactics. Specifically JUUL, the largest e-cigarette and vaping company in the U.S., has removed their candy flavored “pods”, cleared out their social media, and given their website a sleeker and more mature look. With these changes, it appears they (along with other companies like IQOS) are now focusing their marketing on adults who currently smoke or adults who are looking to quit smoking.
Use in Tobacco Cessation
One of the most commonly asked questions when it comes to e-cigarettes and vaping products, and the question I decided to start this blog off with, is whether or not these devices are useful in quitting combustible cigarettes and other tobacco products. In a world that loves clear-cut answers, this one will certainly be unsatisfactory, and it is: we don’t know. Like long-term health impacts, there is still a need for more research on this topic moving forward. However, it should be noted by all who are considering using any form of these products that there currently is no evidence to support their usefulness in tobacco cessation. There is also concern that dual-use (i.e. use of an e-cigarette/vape and use of combustible cigarettes/tobacco products at the same time) may occur in those who try to use e-cigarettes to quit smoking. Additionally, e-cigarettes have not been approved by the FDA as an aid for quitting smoking, but there are currently seven approved quit medications that you can learn more about on our most recent tobacco blog.
The bottom line is that while these devices may be safer in some aspects, safer does not mean safe. Specifically, e-cigarettes and vapes are not safe for youth, people who are pregnant, and people who do not currently use tobacco products. There are numerous cessation aids and strategies that have been shown to be successful for people looking to quit their tobacco use, all of which should be considered first and foremost.
–
Have additional questions about a blog topic or just interested in finding out more about Unified’s Tobacco Reduction services? Contact your local Tobacco Treatment Specialist:
It’s fair to say that our lives feel completely different than they did a month ago, with COVID-19 and stay at home orders turning our world upside down. This ever-changing new normal results in the loss of our daily routines and increased uncertainty about what the future may hold. Many of us are experiencing increased feelings of stress, frustration, boredom, anxiety, and depression. As such, it’s important to find a way to establish a sense of normalcy in our daily lives.
COVID-19 and Tobacco Use
For people who currently smoke, there are additional health concerns when it comes to dealing with the COVID-19 pandemic (as discussed in the most recent tobacco blog). COVID-19 is a lung infection, and therefore people who currently use tobacco are at a higher risk of developing more severe and/or prolonged symptoms if they do contract the virus. In addition to physical health, COVID- 19 can contribute to emotional triggers that may lead to an increased want or need to smoke. This can have a negative impact on your goals to reduce or quit your use, or even just increase your tobacco use overall.
Why bother with a routine?
Having a daily or even a weekly routine can help support your physical and mental health, and help prevent an increased reliance on tobacco products. For some individuals who smoke, their tobacco use may be seen as one of the only things in their life they have full control of, and a global pandemic will likely only contribute to that. Having a routine may help provide structure to your day and give you a sense of control over your daily life during this time.
What should my daily routine look like?
It’s important to remember that your routine doesn’t need to look exactly like anyone else’s, have every minute of every day scheduled, or completely deviate from your current (or non-pandemic) routine. Your routine also doesn’t have to incorporate all of the following components, but rather use them as ideas to start structuring your life during the COVID-19 pandemic.
Maintain a sleep schedule – keeping a consistent sleep schedule is important for your health in general, but during quarantine especially. Waking up and going to bed at similar times each day helps keep your days structured and promotes healthier sleep.
Get dressed for the day – when you don’t have anywhere to go it can be very tempting to remain in your pajamas all day. But getting dressed (or at least changing into something other than what you slept in) keeps your mornings consistent and allows for predictability in your life during an unpredictable time.
Socialize while social distancing – perhaps one of the biggest changes as a result of the stay at home order is our new inability to spend time with other people in person (or at least other people who we don’t live with!). Even for those who often prefer to spend time alone, forced isolation can have a huge negative impact on mental and physical health. Fortunately, we live in a very tech-savvy time and physical presence isn’t always required for socializing with loved ones. Make plans with friends or family to have regular calls, text conversations, or video chat sessions. Or plan to read or watch the same books and movies together (Detroit and Ypsilanti public libraries have options for e-book downloads).
Get moving – for most people, increased time at home means less daily physical activity with most of the time we spend walking to or into different places being replaced by more time sitting or lying down. Finding ways to increase your movement throughout the week is important for your overall health, and can help you manage cravings. Take walks, have dance breaks, stretch/do yoga, go up and down stairs, or anything else that may get you moving.
Don’t forget about meal times – eating meals as normal provides structure to your day. Try and eat around the same time each day and try to move to a new location to eat if you find yourself in one spot for most of the day.
Do activities you enjoy – this is NOT going to be a blog that tells you you should be mastering your second, third, or fourth language by now. But, it is a good idea to try and incorporate activities you enjoy throughout your weekly schedule. Planning out time during the week to read, cook, watch favorite movies, knit, play games, etc. is a good way to boost your mood and keep your mind off smoking. This could be something you do for everyday, or for a few times throughout the week.
If you’ve read my previous blog, or if you’ve worked with me in the last few months to develop your tobacco reduction/quit plan, you probably know that I often encourage making small changes and building on those to create a larger, positive change. We’ve been dealing with a major change over the last month, and it’s been overwhelming to say the least. Remember the goal with creating a “quarantine routine” is to help deal with that change, support your physical and mental health, and hopefully keep you on track with your tobacco reduction/cessation goals (even if that goal is to just maintain the amount you’re currently smoking!). Pick one or two of the above ideas and see if they help to start, and go from there. Lastly, remember there are some days where routines will just go out the window, that’s normal and it’s okay to need those days!
–
Feel like you need to adjust your tobacco treatment plan due to COVID-19 or just interested in finding out more about Unified’s Tobacco Reduction services? Contact your local Tobacco Treatment Specialist:
UNIFIED 