Helping Hospitals Lead the Way in Smoking Cessation

Helping Hospitals Lead the Way in Smoking Cessation

Most mornings, Steve Rotar would light his first cigarette before he turned off his alarm. He’d smoke his last one in bed at night, right before he switched off the light. 

Rotar’s nicotine habit started when he was in middle school. At its worst, he was smoking as many as 60 cigarettes a day. 

“The first time I tried to quit, I was 16 years old,” he says. “Over the years, I tried hypnosis, a patch, pills and cold turkey.” 

But in late summer 2009, he took a smoking cessation class offered through Wake Forest University Baptist Medical Center in Winston-Salem, N.C. Taught by the hospital’s health promotion and special events coordinator, the classes are part of a new Quit-Tobacco initiative being launched at hospitals across the state. 

A two-year grant from The Duke Endowment to the North Carolina Hospital Association and NC Prevention Partners is supporting the Quit-Tobacco effort.

Putting Wellness Center Stage

The goal is to help hospitals support employees and patients in quitting the use of tobacco. NC Prevention Partners, a nonprofit based in Chapel Hill, N.C., is guiding the effort. 

“I fully believe we will lead the nation in this vital health initiative,” says Dr. Melva Fager Okun, senior health program manager at Prevention Partners. “We have the funding, the staff, the tools, excellent leadership at our hospitals, and a track record of working together.” 

Established in 1998, N.C. Prevention Partners is no stranger to working in North Carolina’s hospitals. From 2006 to 2009, the organization helped all acute care hospitals in the state become 100 percent tobacco-free—the only state in the nation to achieve this milestone. 

The Endowment supported that program, too, along with an effort to revolutionize nutrition standards in hospital cafeterias, vending machines and at hospital-related events. 

In 2009, N.C. Prevention Partners began developing the comprehensive tobacco cessation model that would become the Quit-Tobacco initiative. The Duke Endowment awarded a $250,000 grant to support the first-year effort, followed by a two-year, $500,000 grant in 2010.

The Smoking Toll

Bill Pully, the N.C. Hospital Association’s president, said he’s excited to see the scope of Prevention Partners’ work unfold within North Carolina hospitals. 

“This new Quit-Tobacco initiative helps hospital employees and patients be healthier by quitting tobacco,” he says, “but it’s also a financially wise thing to do because healthier employees cost less and are more productive.” 

And when health care workers quit using tobacco, the idea goes, they’ll be better able to help patients who smoke. 

More than one in five adults still smoke in North Carolina, which contributes to the fact that life expectancy in the state is two years less than the national average. And according to a recent article in the North Carolina Medical Journal, tobacco use costs the state $4.75 billion each year. 

So far, 18 of North Carolina’s 125 acute care hospitals are participating in the Quit-Tobacco initiative, from large and urban to small and rural. As part of the effort, they’re taking steps to: 

  • Identify all tobacco-using employees and patients, educate them and advise them to quit, refer them to medications and counseling, do follow-up
  • Offer and promote cessation benefits at no-cost or low-cost, include counseling, and access to prescription and over-the-counter medications
  • Provide and promote incentives to motivate employees to join cessation programs
  • Establish tobacco use as a vital sign or required field for patient medical records
  • Offer cessation medications, both prescription and nicotine replacement therapies, counseling, and community follow-up, make referrals to the N.C. Quitline
  • File reimbursements for patient coaching

“We did not get into this problem overnight and we are not going to get out of it overnight,” Okun says. “It’s like we are trying to change the direction of an ocean liner. But we can now look at North Carolina and say that absolute, concrete steps are being taken. The hospitals are leading the community.”

‘I Get to Celebrate’

Steve Rotar was 16 when he first tried to quit. Now 49, he says he lit his last cigarette on Sept. 23, 2009. 

“Two to three packs a day obviously took a physical toll,” says Rotar, who lives in Winston-Salem, N.C. “I feel so much better today.” 

On his one-year anniversary, he sent an email to Chandra Parker, his smoking cessation coach at Wake Forest University Baptist. 

Because of your efforts, I get to celebrate today!
I get to celebrate one year of not smoking for the first time since I was 10 years old.
I get to feel the sense of satisfaction that comes with a one-year anniversary.
I get to breathe a little easier.
I get to smile a little “whiter.”
I get to feel proud of accomplishing a goal that I have tried to accomplish four or five times over the years but failed to accomplish.
I get to spend much less time in line at convenience stores buying cigarettes.
I get to taste a little more.
I get to spend that money on something that I want, rather than something that I need.
I get to smell a little better.
I get to hold my head up and feel like a non-smoker.
Because of your efforts, I get to celebrate today!

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Lin B. Hollowell III
Director of Health Care


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