A breath of fresh air: Increased smoking cessation aid at St. Michael's College

In the courtyard framed by the three academic buildings at Saint Michael's College, cigarette butts litter the ground and adorn the ashtrays that top trashcans. Before class, students hurriedly inhale one last puff before rushing off to their academic endeavors. After class is released, it is not long before the air is perfumed by smoke once again. Tobacco use on-campus and among students has become a part of life at St. Michael’s but this culture could change in the near future.

As of April 2, approximately 1,500 of the over 4,000 colleges and universities in the United States have implemented a 100 percent smoke-free campus policy, according to Americans for Nonsmokers Rights. Higher education institutions in Vermont are no exception to the smoke-free trend. In the spring of 2014, Dr. Harry Chen, medical director for the Vermont Department of Health, called a consortium of all of the Presidents of Vermont colleges and universities and asked them to consider changing their campuses to be tobacco-free, because of the major health impacts tobacco has on everyone in a campus environment.

Many students at St. Michael’s, both smokers and the “silent majority” of non-smokers who do not want to limit the rights of their peers, are not in agreement with a conversion to a tobacco-free campus, but the administration has made it known that a policy will likely be implemented in the coming years. Smokers constitute approximately 12 percent of the St. Michael’s student body­­—a figure slightly below the 14-15 percent national average of 18-25 year old smokers— and are facing a big change. With the hope that many will choose to quit, the school plans on increasing the amount of aid available to smokers beginning in the fall.

Though St. Michael’s has made no formal announcement on the implementation of a tobacco-free campus policy, students looking for aid in the difficult process of smoking cessation need not necessarily wait until the fall to get help. Mary Masson, director of Student Health Services and nurse practitioner, says that if a student decides to quit smoking entirely, wants to cut back on his or her tobacco intake, or simply desires more information on the topic, St. Michael’s students have plenty of resources for aid in smoking cessation now, but will have even more aid options available to them starting in the fall semester. Also a director of St. Michael’s Tobacco-Free Task Force, Masson adds that students who do not smoke before the age of 26 have a 98 percent chance of never smoking. If St. Michael’s becomes tobacco-free, a huge number of students may avoid the risk of becoming addicted to tobacco.

As part of the plan to increase smoking cessation aid for students, and decrease the number of student smokers, nurse practitioners at Health Services will ask every student who comes in if he or she is a smoker. If a student replies in the affirmative, the nurse will then offer the student a free one day sample of combination therapy, one of Masson’s top tips for students who are attempting to quit. Combination therapy is a form of Nicotine Replacement Therapy (NRT), where a smoker combines two or more types of treatments that provide the body with the nicotine it craves, and steadily diminishes the addiction by decreasing the amount of nicotine the body absorbs over a period of several weeks. The American Medical Association recommends smokers combine a long-term form of nicotine replacement, like the patch, with a short-term aid, like gum or lozenges. NRT doubles the odds of success of smoking cessation, says the American Medical Journal. Because of NRT’s effectiveness, a one day sample could encourage student smokers to attempt cessation. Masson says, “even giving up for a day has health benefits.”

A second tip Masson offers to students looking to quit smoking is to not make the attempt alone. In order to provide peer support to smokers attempting cessation, Health Services is looking to establish group therapy sessions provided by 802 Quits. 802 Quits is a statewide program run by University of Vermont’s Medical Center Employees who provide in-person support for smokers considering, or in the process of, cessation. Amy McRae, a tobacco-treatment specialist at 802 Quits, says she prefers to work with people “in small groups of five to ten people,” because it is proven easier for smokers to quit if they have a support from others who are going through the same process.

One program 802 Quits offers, which Masson hopes to implement at St. Michael’s, is a five week class to aid smokers by helping them make a plan for quitting. The class helps smokers set a date that they are going to quit, which is normally within 30 days of their first session, says McRae. Once the “quit date” has been established, 802 Quits can then provide NRT to patients free of charge. For additional support, the program offers online chatrooms and phone-based support for instantaneous help in a difficult moment.

The numerous assistance programs provided by 802 Quits are a great resource to anyone looking for help, or simply more information. Though NRT cannot be given to people under the age of 18, the classes are open to anyone, regardless of how frequent his or her tobacco use, or what age he or she is. “802 Quits has the best smoking cessation program in the country,” says Masson. “You don’t even have to be a Vermonter, being a college student qualifies you for the program.”

“It’s Personal.”

Both Masson and McRae agree that NRT, making a plan, and having support are key components of successful cessation, but personalizing the attempt is important as well. Jamie Bender, a sophomore at St. Michael’s, began smoking his senior year of high school, but decided to quit after his first semester of college. Bender decided to quit without aid in the form of NRT, and used his athletics as motivation for quitting smoking and improving his health. After decreasing the amount of cigarettes he smoked on a daily basis, Bender then used distraction as a way of quitting. When he wanted a cigarette, he would instead busy his hands with video games, or hang out with his friends who did not smoke. Though cravings continued for almost a year after he stopped smoking, Bender found that by writing down his goal, and rewriting it every day, the task he set for himself became tangible, and more manageable. An unconventional, yet successful, approach to smoking cessation, Bender’s story is proof that smoking cessation is a customizable experience. It is important for every smoker attempting cessation to make a quit approach that is the “best fit” for him or her, so that it is more realistic method for him or her to adhere to, says McRae.

Unlike Bender, who began smoking in high school, many students begin smoking in college, according to Masson. Though quitting for students may be easier than for staff, since it is highly likely that college-aged people have been smoking for a shorter amount of time than older staff members, smoking cessation is not an easy process, and it is important to remember not to get discouraged. Masson says, “It’s a difficult thing to do, which is why we want to support students and staff attempting to do it, but most people don’t succeed on their first attempt. It takes several tries. I think people can get discouraged and then they feel like they can’t do it, but every try is one step closer.”

With the understanding that smoking cessation is difficult, Masson says St. Michael’s does not expect 100 percent compliance with any tobacco-free policy immediately after it goes into effect. Joe Humes, a junior at St. Michael’s, enjoys smoking cigarettes outside of his Ethan Allen apartment building on St. Michael’s North Campus. Humes describes himself as a recreational tobacco user, and is one of the many students opposed to a tobacco-free policy going into place. Should the policy be implemented, Humes says, “a successful tobacco-free policy on campus would take a few years of refining the enforcement approach to effectively and fairly apply it across the entire campus.” Masson, prepared to wait for results, says the school is expecting a gradual decline in the number of smokers on campus, and that decreasing the number of students who smoke by one or two percent a year would be progress.

Four years ago, Howard Community College in Howard County, Maryland, became a smoke-free institution. Director of Student Life and co-chair of the Smoke-free Committee of Howard Community College (HCC), Dr. Llatetra Esters says there were “hiccups along the way,” of the policy’s implementation, but the school has to understand that it is a new policy and it takes time for students and faculty to adjust to the change. Enforcement is applied at HCC through a $50 fine charged to anyone found violating the policy, faculty and students alike. “Some people were not happy, and new people to the institution have to learn about the policy, but there is a visible change on campus now that it is smoke-free,” says Esters. “The open areas that used to be filled with cigarette smoke are now clear.”

Between NRT and support groups, phone counseling and making a plan, there are many ways for smokers to approach cessation. Perhaps one day in the not-too-distant future, St. Michael’s will be like Howard Community College, with courtyards free of both cigarette butts and gusts of smoke. There is help for those attempting cessation if they reach out for it, and though Health Services is increasing its aid in the fall, anyone can begin to quit smoking, or educate themselves on the process, now and find the degree of help they desire.

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