One of the most common New Year’s resolutions is to quit smoking, but any day is the perfect day to stop, says Monica Gilles, MAS, RRT, NCTTP, a clinical care coordinator and tobacco cessation counselor for the Rutgers Cancer Institute of New Jersey, Cancer Health Equity Center of Excellence. Studies show the sooner you quit tobacco usage, the sooner your vitals return to normal, your appetite resumes, you fully regain your sense of taste as it was pre-tobacco, and your body rids itself of chemicals like arsenic and formaldehyde. We spoke with Gilles about talking to your teens about smoking and vaping, the resources needed to help them quit, being compassionate with yourself as you begin your smoke-free journey, and what else you can do to improve your health.
New Jersey Family: What percentage of kids are using tobacco, and are those numbers trending up or down?
Monica Gilles: The youth population is smoking more and more, and that includes vaping devices, e-cigarettes, hookah devices–all the smokeless tobacco products. We know that in New Jersey, about 11% to 12% of middle school and high schoolers are vaping. Smoking rates have come down in the United States; however, there are still populations of individuals who are smoking, and those are the people we try to reach.
NJF: At what age do teens typically start experimenting with tobacco? Is vaping a gateway to cigarettes or vice versa?
MG: We notice that it’s becoming younger and younger. We have middle schoolers who are smoking, and that’s around 8th grade. Unfortunately, kids do use vaping devices, and we fear they may start using traditional combustible cigarettes.
NJF: What are some factors that are influencing children and teens to start smoking or vaping?
MG: The media. We know some e-cigarettes are made with rainbow colors to entice the LGBTQ+ community and other individuals. It’s marketing. If you see someone with a highlighter in their mouth or something like a soda bottle – they have a little Coca-Cola-sized vaping product – it could be an e-cigarette. Or they look like highlighters or smell fruity. Or are designed to look like SpongeBob SquarePants.
We also see older siblings or family members who are smoking around children or young adults. According to the data, we always say it’s by example. You will find if parents smoke around their children, their children have a higher likelihood of becoming smokers themselves.
ScreenNJ is a statewide service that provides education about cancer prevention and detection to the community and professionals. ScreenNJ supports NJ residents to obtain cancer screening through navigation and mobile health services regardless of their ability to pay. For more information about ScreenNJ visit screennj.org.
NJF: What are the health risks linked to using tobacco?
MG: We know the brain is still developing up until age 25. When the young developing brain has nicotine too quickly or at a younger age, the prefrontal cortex, which is responsible for critical thinking, behavior and modification, unfortunately doesn’t have an opportunity to develop.
Not only that, we’ve heard of kids having lung diseases that are linked directly to e-cigarettes. We don’t know enough about the long-term health effects of e-cigarettes. However, the same chemicals that are found in combustible tobacco are also found in e-cigarettes, like arsenic and formaldehyde.
NJF: What physical methods are available to help people quit?
MG: We can figure out based on an interview and thorough intake what your behavioral patterns are, how long you have been smoking, what you smoke, how often you smoke, and how old were you when you first started smoking. The earlier you start smoking, the more addicted you can become because the brain is still developing. For individuals who smoke before the age of 18, nicotine addiction is harder to break.
Anyone under the age of 18 would be seen by a pediatrician to get the proper dosing of their nicotine replacement. Adults over 18 would call a free quit line to get the traditional nicotine patches or nicotine gum, which can still be prescribed to a younger person but under a pediatrician’s guidance.
There are seven FDA-approved cessation medications, and it’s not one-size-fits-all. The patch and the gum come in different strengths, so we need to do a full assessment.
Cold turkey is not for everyone. We have a small percentage, maybe no more than 7% of individuals, who can quit using the cold turkey method. Unfortunately, for most people, their nicotine addiction is not properly managed, and that’s why they go back to smoking.
NJF: How do you treat the behavioral aspects of smoking?
MG: The best form of treatment would be behavioral modification and pharmacologic intervention together because it’s not only the addiction component, it’s also behavioral.
Avoid temptation by getting rid of all your tobacco products. Tell your network of friends and family that you will be on a quit journey so they will be supportive and they will understand how hard it is. Let people know you’re on a journey to be smoke-free and to respect your presence by not smoking around you or not offering you products.
It’s a habit. If someone has their hand to their mouth at all times, we give them tricks, like getting rid of all your tobacco products, twirling a pen or pencil in your hand, and changing your daily routine. If you wake up and the first thing you do is smoke, make sure there are no tobacco products at your bedside and take a shower. If you normally associate having coffee with your tobacco products, don’t have your coffee first thing in the morning, maybe go for a walk first. I’ve had women say to me they have taken up knitting to keep their hands busy.
NJF: How important is communication in terms of helping kids quit?
MG: Through ScreenNJ, I’ve had the pleasure of going into high schools and doing presentations. We talk about some of the people whom kids may want to trust if they don’t feel comfortable speaking to their parents: a social worker, guidance counselor, one of their teachers, or even police officers or school security. We know that pediatricians are starting to, during their visits, ask parents or guardians to leave the room so they can speak to the young adults.
We don’t want to lecture teenagers because they’ll tune us out. Instead, we talk about interventions and helping them live healthier lives. With children who are on sports teams, you can speak to them about their lung health. That may encourage them to not vape or be around people who are vaping.
Your children do not want to be criticized, so parents should encourage open dialogue. Remember, the goal of the conversation is to not deliver a lecture but to speak to them. We do know that that approach will have the kids open up even more.
We hope that schools start tobacco cessation programs of their own, or have a tobacco treatment specialist on hand.
ScreenNJ is a statewide service that provides education about cancer prevention and detection to the community and professionals. ScreenNJ supports NJ residents to obtain cancer screening through navigation and mobile health services regardless of their ability to pay. For more information about ScreenNJ visit screennj.org.
NJF: How can you encourage people who have tried to quit but are not successful at first?
MG: You must be patient and kind to yourself. Depending on how long you have been smoking, it can take most people up to eight or more tries before they quit successfully. You have to be compassionate with yourself because addiction is not easy. Everyone would just quit if they could quit.
If you slip up, it’s okay. That doesn’t mean that you don’t continue on your journey. Start again the next day. If you wind up smoking more than you anticipated, it’s okay – try harder the next day.
There are also many days of advocacy. There’s the Great American Smokeout every November, which gives people an opportunity. If you can quit for one day, then maybe you can quit for day two, day three and so on. November itself is Lung Cancer Awareness Month. We have World COPD Day. There’s World No Tobacco Day. I try to use all those occasions to reach out to the community.
NJF: How much is your risk of disease or cancer reduced once you stop?
MG: We know that long-term use of tobacco, even after someone does quit, may still make them susceptible to certain diseases. Smoking is the biggest single driver of all cancer deaths, not just lung cancer. Unfortunately, aging is a risk factor that would cause someone to still be at risk for certain diseases.
I’ll give an example of why it’s good to quit as soon as possible. Let’s say a person has a doctor’s appointment and they smoke in their car before entering the building. The nurse will take their vitals: heart rate, blood pressure and oxygen levels. Within 20 minutes after the person has not smoked, all those numbers go down to normal. The benefits of not smoking can be seen immediately.
We know between a month to two months, your sense of smell increases because you don’t have all those chemicals coating your tongue. The appetite increases because you have less of the chemicals in your system.
Not smoking is the best possible thing you can do for your health, and somechanges can be seen pretty quickly.
NJF: Smoking is not only harmful to our health, but it’s also expensive. Is this a factor in reducing smokers or quitting early?
MG: I did a presentation for a recovery center, and I showed that in New Jersey, compared to the rest of the country, we came in at about 14% with the amount of tax that we tack onto our tobacco products. New Jersey tacks on about $2.70 per pack of cigarettes, whereas the rest of the country, I believe it’s $1.91. There were about 30 individuals, and they said this was not a deterrent for them. Depending on your socioeconomic status, it may or may not be a deterrent.
NJF: What is your best advice to prevent smoking?
MG: Education, education, education. We need to remind people that our lungs are not supposed to receive any type of heat. I think you need to show evidence-based information about what smoking can do to the human body, and not just your lungs. Prevention, outreach and engagement like tabling events and health fairs that we do at ScreenNJ provide people with the information early, and I think it gives them better information on how to safeguard their health.
Making connections within the community has been so beneficial to a lot of people because we have so many resources that people may not have known were out there.
Monica Gilles, MAS, RRT, NCTTP, is a clinical care coordinator and tobacco cessation counselor for the Rutgers Cancer Institute of New Jersey, Cancer Health Equity Center of Excellence.
Read More:
How To Talk To Your Kids About the Dangers of Tobacco and Alcohol Use
How Healthy Choices Can Reduce Your Cancer Risk