"Smoking Cessation" by Allen Weiss, MD, MBA, President & CEO

Smoking Cessation

November 1, 2011 -  November is National Smoking Cessation month and there is important news for everyone; this should motivate smokers to stop, help those who can’t stop discover if they have lung cancer in its earliest stage, and keep everyone else from starting.

“About half of all smokers will be killed by tobacco if they don’t quit,” admonishes Dr. Thomas R. Frieden, Director of the U.S. Centers for Disease Control and Prevention (CDC) and Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR). He was New York City Health Commissioner from 2002–2009 (and both of us are graduates of Columbia University’s College of Physician and Surgeons).

The CDC recently reported that the five year decline in the number of people who smoke is less than seen over the previous 40 years. We are now down from 21% to 19.3% of Americans admitting they smoke. Dr. Frieden continues, “You don’t have to be a heavy smoker or a long-term smoker to get a smoking-related disease or have a heart attack or asthma attack. The sooner you quit smoking, the sooner your body can begin to heal.”

In an effort to improve our environment at NCH, we have addressed our nation’s most noxious health hazard—smoking—by initiating a policy in October to not hire smokers. This policy already exists at Cleveland Clinic, Humana and other healthcare institutions, which have also shown improved healthcare experiences for their employees. At the same time, we will continue to encourage our colleagues who do smoke to take advantage of the Area Health Education Centers (AHEC) tobacco cessation program to “Quit Smoking Now” and add an average of 10 years to their lives. Less than 12% of the NCH staff currently uses tobacco.

The best news from this effort – along with other specific recommendations to stay healthy such as age and gender specific screening, healthcare coaches—is that the health of the 3,750+ NCH employees and their spouses has improved. We anticipate that our health care costs will not increase and, in fact, will decrease significantly which is contrary to most everyone else. So not only are we getting healthier physically, but financially as well.

If you do smoke, or did smoke in the past, you can decrease your chances of dying from lung cancer by undergoing annual screening with low-dose Computed Tomography (CT scan) of the lungs. This radiology test is offered locally for a modest cost of between $99 and $150. Considering the price of a pack of cigarettes, spending money to increase your chances of living by 20% to discover lung cancer early is a real bargain.

Lung cancer remains the leading cause of death from cancer in the United States, according to a recent New England Journal of Medicine article. The report shows the efficacy of CT scans in those who are between 55 and 74 years old and smoked for at least 30 “pack years.” One “pack year” is defined as one pack per day for one year; two packs per day for a year equals two pack years, and so on.

Thirty pack year smokers who quit within the last 15 years can be helped to survive longer if they are screened yearly for three years. There is a risk of “false positives”—meaning a minor abnormality might be mistaken for an early cancer indication. When this occurs, further testing or watchful waiting is necessary. Interestingly, there are seven million Americans who would fit the above screening criteria but an estimated 94 million current or former smokers.

Beginning in September, 2012 the Food and Drug Administration will require larger, more prominent health warnings on all cigarette packages and advertisements. There will be nine graphics—all designed to catch the eye of a smoker or potential smoker.

We at NCH want a healthy workplace, environment, and county. I expect many other businesses will follow suite by not hiring smokers. Non-smokers appreciate not having to deal with the residual smell or the extended breaks.

According to a study conducted by the University of Wisconsin’s Population Department and sponsored by the esteemed Robert Wood Johnson Foundation, our community has been the healthiest in Florida for the past two years. In addition, we have the record for longest life span, according to the University of Washington (State): 87 years for women, and the second longest for men at 81.1 years.

As we all work together to help those who still smoke succeed in quitting, and encourage them to be screened for early cancer detection, we must also endeavor to combat the tobacco lobby as they try to market this terribly destructive habit. While we can continue to be recognized nationally for our good community and individual health, we need to become even healthier going forward. Being able to live long enough to see grandchildren grow up and get married should be a big motivator for every smoker.


Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.