Robin Terrebonne of Martinez tried to quit smoking “about 26 times,” but nothing seemed to do the trick.
Then the 69-year-old got a cough that wouldn’t go away, and she worried it might be a harbinger of lung cancer. That’s when she visited her Kaiser Permanente doctor who prescribed her a nicotine patch to help her quit. She was also referred to a Kaiser Permanente Northern California wellness coach.
About 5.6% of Kaiser Permanente Northern California members still smoke, which is lower than the percentages statewide, at 7%, and nationwide, at 11%.
“They called me, and I said, ‘Sure, I’ll try anything,’” said Terrebonne, who has been smoke-free for 5 months.
Now she has more energy, she can smell again, and food tastes so much better. She even got a personal trainer and started working out.
“The nicotine patch definitely helped,” said Terrebonne. “The wellness coach was someone I could tell if I had started up again without getting judged.”
Like Terrebonne, many of the 316,000 members who quit in Northern California over the last 10 years did so during or after a health event such as preparing for surgery, becoming pregnant, or after suffering a health crisis, such as a heart attack or stroke.
An electronic message reminding physicians to recommend smoking cessation to hospitalized patients resulted in a 5% increase in patients who said they stopped smoking, according to Kaiser Permanente research.
Whether patients need to quit to have surgery or they have simply signaled they are ready, smokers are referred to the wellness coach program, said Nicole Curiel, manager of the Wellness Coaching Center. Prescriptions to help them quit are made in 24 hours.
Teachable moments for quitting
“We designed the Kaiser Permanente smoking cessation program in a strategic way,” said Clinical Lead Renee Fogelberg, MD. “Our focus is personalized intervention that leverages teachable moments when we know people are more likely to quit during those important life events.”
Quitting smoking reduces the risk of premature death and can add as much as a decade of life by reducing the risk of 12 kinds of cancer, having a heart attack or stroke, and getting chronic obstructive pulmonary disease, according to a U.S. Surgeon General’s Report. The same report also noted that quitting has numerous benefits for pregnant women and their babies.
Kaiser Permanente Northern California’s 27 wellness coaches are an integral part of the smoking cessation strategy. They support members motivated to quit with what Dr. Fogelberg calls the “gold standard”: a combination of medication therapy which reduces cravings and behavioral counseling to make the change more sustainable. Members receive 6 coaching sessions over 6 months.
As of May 2024, 5.6% of Kaiser Permanente Northern California’s adult members still smoke, down from 9% in 2014 when the program started as the 50,000 Quitters Campaign. The percentage of Kaiser Permanente smokers today is lower than the percentages statewide, at 7%, and nationwide, at 11%.
It takes most smokers 7 to 8 attempts to quit smoking long term, Dr. Fogelberg said. If a smoker starts before age 18 and smokes more than 20 years, quitting is going to be more difficult. That is compounded if there are other smokers in the house, or if the smoker also drinks alcohol, said Curiel.
“The success rate to quit is going to be much higher with medications and counseling, as opposed to quitting cold turkey,” said Curiel. “We use motivational interviewing, which is incredibly useful in addiction medicine. We never tell people what to do. We want them to feel empowered to make the decisions on their own.”
Customized coaching
“Some people are just ready to quit and some people we encourage to cut back slowly,” said Curiel. “Others have a hard time in the morning, for example, because they like to have a cigarette with a cup of coffee. We encourage people to come up with their own ideas to cope. If they don’t have any ideas, we help them.”
Robin Terrebonne, who started smoking 56 years ago, was one of the more than 4,000 members who quit smoking so far this year.
“I really thought I was going to get cancer,” she said. “But it was so hard to quit. I’m glad I did it though. My kids are happy, too.”
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