Understanding E-cigarettes and Vaping

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“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. 

Background

E-cigarettes are a type of electronic nicotine delivery systems (ENDS), and are also commonly referred to as vapes or vape pens, as well as various brand names (example: JUUL). The devices work by producing an aerosol from a liquid that’s heated within the device by a metal coil, which the user then inhales. “E-liquids” are made up of nicotine, glycerin or propylene glycol, flavorings, and various chemicals. The aerosols that are inhaled may also contain  ultrafine particles and heavy metals like nickel, tin, and lead. 

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 .

E-cigarettes are currently the most commonly used tobacco product among youth in the United States, with over 5 million middle and high school students reporting use within the last 30 days in 2019. Specifically between 2011 and 2015 we saw a 900% increase in use within this demographic. Some (and likely most) of this growth can be attributed to the youth-oriented marketing that has been present in the last 5-10 years. Examples of this marketing include brightly colored ads (like the one below), social media use (including hashtags like JUUL’s #vaporized), promotion through celebrities and “influencers”, and youth-targeted flavors (fruit, candy, and mint). These efforts have succeeded in reaching U.S. youth, with more than 5 in 10 (over 14 million) middle school and high school students reporting seeing e-cigarette advertising in 2018. 

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

You can find more information on health risks and resources for discussing e-cigarettes (particularly with youth) on the CDC, Michigan Department of Health and Human Services, and Surgeon General webpages for e-cigarettes and vaping. 

Regulations 

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:

Detroit:
Amber Jager – (269) 350-3826
ajager@miunified.org

Ypsilanti/Jackson:
Caitlyn Clock – (734) 489-9916
cclock@miunified.org 

Building Your Quarantine Routine

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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. 

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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
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  • 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). 
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  • 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. 
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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:

Detroit:
Amber Jager – (269) 350-3826
ajager@miunified.org

Ypsilanti/Jackson:
Caitlyn Clock – (734) 489-9916
cclock@miunified.org 

Time Management and Tobacco Reduction: Tips to Get Started

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What is Time Management?

In our first tobacco workshop of the year, clients discussed the idea of looking at time management in two different ways:

  1. Having too many tasks, appointments, etc. and feeling as if there isn’t enough time to get them all done.
  2. Having too much free time and not knowing how to fill it.

Both of these situations can be overwhelming, and both can lead to an increase in feelings of stress, anxiety, frustration, and loneliness/depression. Which can result in an increased want or need to use tobacco products. Stress, in particular, is a commonly cited barrier for people attempting to quit their tobacco use, and often plays a role in slips and relapses during quit attempts. 

So how can one start to utilize time management skills in their daily life? Something I noticed when exploring ideas for this month’s blog is that most articles and blog posts offering time management tips revolve primarily around productivity and efficiency in the workplace. While productivity-based skills can be incredibly useful in many settings, they often don’t prioritize an individual’s overall wellbeing. The following list includes my top time management tips.

  • Start Small. It’s important to remember not to overwhelm yourself with major changes, even when they may benefit you in the long run. Scheduling every minute of every day is unnecessary and likely to increase negative feelings if you’re unable to meet those detailed time frames. Start with marking down important appointments and deadlines, and see what else would be helpful from there. 
  • Use a Planner or Calendar. While it seems obvious, using a calendar or planner can help you keep track of appointments, events, and other commitments. Keeping track of these will allow you to make appointments as needed while also helping to prevent you from double or overbooking yourself. Having these things planned out will also allow you to prepare for them.
  • Become a List Maker. Using lists can be incredibly helpful when you feel like you’re just not getting things done that you need to. Not only can they serve as a reminder for what needs to be done today (or tomorrow, or this week, etc), crossing off tasks as you complete them will provide you with a visual of how much you’ve accomplished.
  • Break Up Your Big Tasks. Oftentimes major tasks can seem intimidating and we can end up putting them off to avoid feelings of failure and anxiety. By breaking these big tasks up into multiple smaller ones, you can gain confidence in getting through your to-do list without trying to put them off. 
    • For example: You were sick in bed for a week and missed multiple appointments with your doctor, your case manager, your tobacco treatment specialist, your therapist, and a class. Rather than trying to reschedule everything in one sitting, space the calls (and the appointments) out with breaks in between. 
  • Prioritize! Though time management skills can certainly be helpful, they can’t change the fact that we only have 24 hours in the day and seven days in the week. Take time to determine which tasks are the most important, and which one(s) can wait until you have more time available.
  • Make Time for Yourself. While making it to your appointments and other commitments is important, remember that it’s equally important to set aside time for yourself to do things you enjoy whether that’s reading, taking walks, spending time with loved ones, or watching movies. 
  • It’s Okay to Say No Way. These tips and skills are supposed to help reduce stress, anxiety, and frustration in your daily life. Recognize that it’s okay to let people know when you have enough on your plate for that week and need to schedule for a better time in the future. 
  • Celebrate! With any change in your life, it’s important to remember to recognize your accomplishments even if they seem small. Made it on time to an appointment you’d missed and rescheduled a few times? Have a small treat! Completed a major task that’s been looming over your head for weeks? Give yourself a night where you can focus on relaxing and doing activities you enjoy.

As you begin to plan ways to put some of these tips to the test, remember that different things work for different people. Maybe most of these will work for you, or maybe only one will. Don’t be afraid to adapt these tips to benefit YOU and your time management needs. Ultimately, the goal is to find ways to help manage feelings of stress, anxiety, frustration, depression, and boredom that might lead to an increase in your tobacco use. 

Interested in finding out more about Unified’s Tobacco Reduction services? Contact your office’s Tobacco Treatment Specialist:

Detroit: 
Amber Jager – (313) 446-9800 
ajager@miunified.org

Ypsilanti/Jackson: 
Caitlyn Clock – (734) 961-1077
cclock@miunified.org

Quit Smoking Tip of The Week: Keep the weight off! Part 3

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So far we have covered nutrition and exercise as tools for a healthy weight and lifestyle. Now, third but definitely still just as important as the former two, is sleep! We often disregard or forget about this oh so important factor altogether, in the go-go-go lifestyle that comes along with our society. Sleep is one of the most crucial ingredients for health and well-being. Sleep is what regulates your hormones, repairs your body, promotes a healthy mental state, and so much more.

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If weight loss is your goal and you’re eating healthy foods and working out but not seeing much progress, it is time to evaluate your sleep. Not only will your “gains” from working out be lost if you are deprived of sleep, but your body will crave more food to help fuel your body as it goes into “overtime,” and usually the foods we crave are not the foods we need for proper nutrition. Let’s dig a little deeper, here, and see what else is effected by sleep and HOW to get the most out of your sleep!

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In addition to getting enough sleep (a recommended 6-8 hours for adults), the timing of your sleep is also crucial. Research shows that your body starts to release melatonin in the evening as it starts to get dark out, then begins to release cortisol as the sun begins to rise. Melatonin is the sleep hormone responsible for putting your body at rest and cortisol is the sleep hormone responsible for waking your body up. An optimal sleep schedule is to sleep from 10pm to 6am (8 hours), as 10pm-2am is the time in which your body reaches its peak hormone balance to promote optimal restoration for your cells. When you stay up too late, or sleep in too late, your body is thrown off by hormone dysregulation. This can explain why you may still feel tired even after getting a solid 7-8 hours of sleep, because getting 8 hours of sleep from 12am-8am, is not the same as a 10pm-6am schedule. When you go to sleep at 12am you have already missed the first two hours of REM sleep. Dr. Oz has a great article going deeper into the science behind the 10pm-2am cycle of restorative sleep here if you’re interested in learning more.

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What happens to your body when you get a good night’s sleep? A ton of great things, such as:

  • Blood sugar regulation, important for preventing type 2 diabetes
  • Your muscles rebuild themselves, utilizing essential amino acids that you have digested throughout the day (making your workout actually worth it!)
  • Your body repairs itself from internal and external stressors (inflammation reduces, mood regulates, free-radicals that cause disease are removed, all thanks to the antioxidant properties of melatonin)
  • Long-term memory is reinforced, helping you perform cognitive tasks more efficiently

All of the above (expect for the last point, which should still be an important factor for people) aid in weight loss. When you don’t get a quality amount of sleep, the above either will not happen or will occur at a much less efficient rate.

So, get those ZZZ’s because they’re a lot more important than you think!

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Setting a routine for better sleep

Now, let’s address HOW to get this restorative, restful sleep, because as we all know, insomnia can be a withdrawal for many smokers who begin their quit journey.

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  • Only use your bed for sleep and sex. When you do other activities in your bed (such as reading, watching tv or eating) your brain does not associate your bed with sleep as strongly, and your bed should only be associated with relaxation.
  • When you can’t fall asleep, get out of bed. This might sound like bad advice, but it goes along with the first tip. If it is taking you up to an hour to try to fall asleep, get out of bed and read on the couch or stretch until you feel sleepy, then hop back in bed. When you can’t sleep and stay in bed, feeling anxious or upset that you can’t fall asleep, you are unintentionally associating your bed with negative emotions.

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  • Exercise early in the day, if possible. It is proven that moderate exercise (try for 30 minutes a day, even if it’s just walking) will help adults get a better night’s sleep. Even further, if you exercise before 3pm you will be getting the most from this benefit as it is also proven that exercising after 3pm can cause your sleep hormone production (melatonin and cortisol) to get post-poned, potentially making it harder to initially fall asleep.
  • Consistency is key. Try to go to sleep at the same time each night, and wake up around the same time each morning. Building a consistent routine around your sleep schedule helps keep your hormones in check and makes it easier to fall asleep (and stay asleep) at night.

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  • Unplug! This one is so important in our busy, always accessible society. At least an hour before going to bed, stay away from your cell phone, computer, tv, or any other electronic device. Read a book, stretch or find another relaxing activity that you can participate in each night as part of your routine to help your body unwind and relax. This will help you rid yourself of your racing thoughts, as well as give your brain a rest by intentionally reducing the blue-light that you are exposed to. Blue-light interferes with our internal clock, which controls our sleep hormone (melatonin), causing hormone imbalance, anxiety and stress.
  • Ditch the late night snacks (or meals). Eating later in the evening and at night is tough on our digestive system. Historically speaking, when the sun goes down, so does our body. And with it, our bodily systems, such as digestion. Remember earlier when I said that our body repairs itself when we sleep? Well, when you eat a meal less than three hours before going to sleep, your digestive system is still doing a lot of work while your body is trying to rest! This might be why you wake up multiple times in the night to pee, can’t seem to get a deep sleep, or even have trouble falling asleep. Do yourself and your digestive system a favor and try to abstain from eating at least three hours before sleeping, four if you’re able to eat dinner earlier.
  • Dim your lights. Our sleep hormone, melatonin, is produced by our pineal gland which gets triggered to release or not release melatonin based on the light we receive. Similar to the idea of unplugging from technology, you should try to reduce the overall amount of light received as soon as the sun starts to set. In this way, you are mimicking the way nature intended and helping produce melatonin naturally in order to induce a restful sleep by 10pm.

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  • Reduce or eliminate your caffeine intake altogether. Caffeine is a stimulant and it has been proven that even having caffeine in the morning can effect your sleep at night. Try cutting down from 2 cups of coffee to 1, or switch to decaf if you really enjoy the taste. Be aware that a lot of teas have a ton of caffeine in them, so opt for the de-caffinated ones or something light like a white tea.

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Coming from someone who has personally had a bad relationship with sleep from my adolescence through my early 20’s, if you try all of these tips, you will be successful in helping to reset your sleep pattern. I never thought that I would have a “normal” sleep schedule, but the fact is most American’s are not getting a restful sleep due to the rise in technology and just lack of knowledge about how our sleep hormones are regulated and what environmental cues can throw them way off. Give it a try for a week, and be amazed that you will not need a sleep aid or other substances to help you sleep anymore! If you suffer from racing thoughts at night, as a lot of us do, and stretching or meditating is not working for you, you can try getting a magnesium supplement to help relax your mind (it also relieves muscle cramps!) or look into ashwaganda root to take mid-afternoon and in the evening for stress relief and relaxation. Always ask your doctor before adding any supplements to your daily regimen as some can interfere with medications.

Tobacco Reduction Program Services

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Happy New Year, everyone! As we enter 2019, most of us have goals of renewing ourselves and refocusing on our health- whether that’s mental or physical. Along with those goals may be a big one: quitting tobacco or continuing to reduce your tobacco use as we enter the New Year. Whether you have never quit before, or have been quitting for the past year, the Tobacco Treatment Specialists at UNIFIED want to help you quit and stay tobacco free- whatever that looks like in your life!

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You may be wondering “Do I qualify for these FREE services, and if so, what exactly do these services provide?” To qualify for the Tobacco Reduction Program at UNIFIED you need to be an individual living with HIV/AIDS, qualify as low-income and live in either the Detroit, Ypsilanti or Jackson area. If you have never received case management services with UNIFIED before but fit the above qualifications, you still qualify for these FREE tobacco cessation services!

So what does a tobacco reduction counseling session consist of, anyways? The short of it, is that it is different for everyone and up to you what you want your reduction and quit plan looks like. We, as tobacco cessation counselors, are here to offer proven-strategies, non-judgmental support and accurate information to help guide your journey to a successful smoke-free life.

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When I meet with my clients, I think of it as them driving the car and me simply navigating the route for them. Most smokers know what they need to do to quit, but need a little guidance to create an individual and effective game plan to get there. That’s where Tobacco Treatment Specialists come in!

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Not ready to quit or reduce, but a little concerned about the health, social or personal implications of tobacco use? Come talk to a cessation counselor! We respect the boundaries of our clients and don’t push when an individual is not ready to make this big change. What we will do is offer information when appropriate, have open conversations about the pros and cons of smoking, and help you decide if it is the right time in your life to quit and give real feedback on what tools (mental coping strategies) you will need when you decide you’re ready to work towards reducing or setting a quit date. There’s nothing to lose by speaking with a tobacco cessation counselor, except maybe a pack of cigarettes or two!

Give us a call today! For our Detroit location, reach Amber Jager at (313)446-9817 and for our Ypsilanti and Jackson location, reach Erin Suprunuk at (734)572-9355.

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Tobacco Reduction – What’s In A Quit Kit?

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By: Kayla Gamino (UNIFIED Tobacco Treatment Specialist)

An ample part of UNIFIED’s tobacco reduction program includes creating quit kits for clients.  During the initial assessment, we bring out the quit kit while discussing possible quit dates.  Each client accessing tobacco reduction services receives 1 quit kit for their time working with the tobacco treatment specialist.  Each quit kit includes: a journal, pens, candy/gum, educational tools, and fidget toys.

Journal- The journal is an especially important piece of the quit kit.  The journal is a good tool to help keep track of a person’s smoking habits prior to their quit date.  Many clients use it to write down when they have cravings, what they are doing when they have cravings, and how they are feeling when they have a craving.  This will help the tobacco treatment specialist and client to better come up with coping mechanisms and a quit plan together for when the client experiences cravings.  For example, if Mike records that he has a craving every time he is feeling bored then coming up with things for Mike to do while he is bored can help combat cravings.

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Pens- The pens are good for when the client needs to journal.  We put 2-3 different colored pens in each quit kit to make it easier for the client to be able to journal. Pens can also act as a fidget toy.

Candy/Gum-  Each quit kit comes with a variety of candy.  We use Twizzlers, Life Savers, and mints normally.  The Twizzlers can help with the hand to mouth habit of smoking.  It is a similar shape to a cigarette.  The Life Savers, mints, and gum are good at combating the oral fixation that often comes with smokers.

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Educational Tools-  In each quit kit, we put a pamphlet for the Michigan Tobacco Quit Line.  In the pamphlet, it gives little facts on how smoking affects the body as well as the number to the Quit Line for clients to utilize.  We also include a UNIFIED Tobacco Services palm card that has contact information and HIV and Tobacco use facts.  As an added bonus, we include the Michigan HIV/STD Hotline number.

Fidget Toys-  Each quit kit includes rubber bands that are used by switching wrists when a craving occurs.  It helps to keep the hands and mind busy.  Additionally, each client gets to choose another fidget toy.  We have two different options.  One is a bike chain fidget toy that is small enough to fit in a pants pocket.  The other is a Bendeez toy that can be molded into different shapes.  Both are used to help combat boredom and keep the hands and mind busy.

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All of these items have gotten positive feedback from current tobacco clients.  If you are a current tobacco user and you think that a quit kit would be beneficial to your quit/reduction attempt, please contact UNIFIED- HIV Health and Beyond to meet with a Tobacco Treatment Specialist!

Introduction to UNIFIED’s Tobacco Reduction Program

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By: Kayla Gamino (UNIFIED Tobacco Treatment Specialist)

A session with the tobacco treatment specialists is different for everybody.  We meet you wherever you’re at and will continue to be there for you every step of the way.  It all starts with a referral from your case manager.  At each visit, they will ask about your tobacco use and assess your readiness to quit.  If you both decide that you are a good candidate for the tobacco program, the case manager will fill out a referral form with you and give it to the tobacco treatment specialists (TTS).

So how is your readiness to quit determined?  Through The FIVE A’s; ask, advise, assess, assist, and arrange.

  • Ask- Your case manager is required to ask every client about their tobacco use at each visit and record it in our records.
  • Advise-  If the client answered that they were a tobacco user, then the case manager will advise them to quit their tobacco use and discuss the benefits of doing so.
  • Assess-  Next, the case manager will assess the clients willingness and readiness to make a quit attempt.  If the client is interested in talking to the TTS about tobacco reduction, the case manager will then make the referral to the tobacco treatment specialist.  In some cases the case manager will refer the client, with the client’s consent, to the TTS before they are considered “ready” in order to get the client thinking about quitting and to help establish the relationship between the client and the tobacco treatment specialist.
  • Assist- At this point, the case manager and the tobacco treatment specialist have touched base and the client is now being assisted by completing sessions with the TTS.  During the sessions, the client and TTS will discuss reduction strategies and possible nicotine replacement therapy options.  These sessions can go many ways depending on the clients needs.  Some clients need to talk about outside sources that are affecting their tobacco use, while others simply want information on tobacco and health.
  • Arrange-  The TTS will arrange follow-ups with the client.  Depending on the clients stage of change and the client’s schedule, the TTS will likely meet weekly or biweekly with the client.  These follow-ups can be by phone or in person.  In some instances, the TTS will also meet the client at their home or a local business.  This is the point in the treatment where the TTS tries to meet the client wherever is easiest for them in order to help make the client more successful in their quit attempt.
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Originally posted by firelordasami

How we assess a client’s stage of change:
The Transtheoretical Model

The transtheoretical model is a behavior change model that was specifically created with tobacco cessation in mind.  The 5 stages of change are precontemplation, contemplation, preparation, action, and maintenance.  It is important to know that the stages of change are not linear (that they don’t go in a single straight order).  Someone can go from being in action to contemplation in an instance.

  • Precontemplation- the client is not ready to quit or is not even considered quitting.
  • Contemplation- the client is considering quitting in the next 6 months.
  • Preparation- the client is ready to quit within the next 30 days.
  • Action- the client is currently on their quit attempt.
  • Maintenance- the client has successfully quit for 6 months.
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Because the transtheoretical model is not linear, a client can attempt to quit many times before being successful.  It is important to know that the tobacco treatment specialists are aware that not everyone will be successful right off the bat.  The specialists are there to help the client every step of the way in a completely non-judgmental environment.  Whether you’ve been working with them for months and relapse, or you met with them once and decided the program isn’t for you, they will always be there for you when you are ready to talk again.

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Want to learn more about UNIFIED’s tobacco reduction program? Visit us online at http://miunified.org/Get-Help/Services/Tobacco-Reduction-Services for more information.

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Introducing UNIFIED

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INTRODUCING: UNIFIED – HIV HEALTH AND BEYOND

Detroit, MI, December 1, 2015. World AIDS Day.  Today, on World AIDS Day, AIDS Partnership Michigan (APM) and HIV/AIDS Resource Center (HARC) introduce the name of their newly merged organization:

UNIFIED – HIV Health and Beyond.

In order to strengthen the response to HIV in Southeast Michigan, AIDS Partnership Michigan and HIV/AIDS Resource Center have merged and will now be known as Unified – HIV Health and Beyond. The merger will enhance capacity in key areas, including programming, access to funding, community-based research and delivery of HIV-related healthcare services. Programming will be expanded for greater impact through shared resources, services and expertise to provide a comprehensive network of support for people at risk for or living with HIV across the region. Unified – HIV Health and Beyond will serve ten counties with a population of nearly five million residents and where 63% of people living with HIV reside. Services will be delivered from the three existing offices in Detroit, Ypsilanti and Jackson.

Rooted in the history of its fight against HIV, UNIFIED – HIV Health and Beyond advances prevention, access to healthcare, community research and advocacy.  The vision for the future is to become a nationally recognized multi-service center creating positive change through regional impact, innovation, and sustainability to promote HIV health and beyond.  UNIFIED will use innovative approaches to help residents of Southeast Michigan living with or affected by HIV achieve optimal health through compassionate direct care, support services, prevention and education.  UNIFIED – HIV Health and Beyond will be an effective and powerful voice, providing leadership and advocacy for the communities it serves.

UNIFIED – HIV Health and Beyond will continue to fight HIV at the grassroots level in both urban and rural communities where it is most prevalent, especially for young people, people of color, men who have sex with men, and injecting drug users.

The following comprehensive HIV services remain available and accessible to all who need them.

• Community Mobilization Campaigns
• Healthy Relationships/Prevention for HIV+ Individuals
• HIV Counseling and Testing
• Hepatitis C Testing
• Medical Case Management
• Medication Adherence Counseling
• Behavioral Health Services
• Tobacco Reduction Services
• Health Insurance Enrollment Assistance
• Michigan HIV/STD Hotline/Website
• Syringe Access and Overdose Prevention
• Peer-Designed Prevention Programs
• Prisoner Re-Entry Program
• Housing Assistance and Homelessness Prevention
• Support service including:
o Food and cleaning supplies pantry
o Emergency financial assistance
o Transportation for medical appointments
o Support groups

By joining together, HARC and APM see themselves as being better prepared for the future and proudly embrace their new name: UNIFIED – HIV and Beyond.  It is only fitting to share this exciting news on World AIDS Day, a day for renewing our global commitment to fighting HIV.

AIDS Partnership Michigan (APM) was formed in 1996 through a merger between Wellness Networks, Inc. and AIDS Care Connection. APM was established to better address the emerging AIDS epidemic in the Detroit/Metro area. AIDS Partnership Michigan has always worked by providing education and services to help prevent the spread of HIV and to help connect people living with HIV to needed services

HIV/AIDS Resource Center (HARC) was founded in 1986 by a group of volunteers to provide HIV/AIDS related services to the people of Jackson, Lenawee, Livingston, and Washtenaw counties. Over the past decade, HARC has developed into a leading HIV/AIDS services provider in Michigan.