Louisville Medicine Volume 62, Issue 4 | Page 23

A top strategy of Healthy Louisville 2020 is to increase physician and health provider referrals to effective smoking cessation programs. One such program is the Cooper/Clayton Method to Stop Smoking. Developed by two University of Kentucky professors, the science-based model uses education, group support and nicotine replacement therapy. Nicotine patches, lozenges and gum help patients overcome their physical addiction to nicotine, weaning them with step-down reductions in dosage over the 13-week course. The program also provides weekly group support sessions led by trained facilitators, many former smokers themselves, to deal with the psychological issues often associated with smoking cessation. The Cooper/Clayton method boasts a 42 percent success rate upon completion of the 13-week course. This compares to a 5 percent success rate among those trying to quit with no nicotine replacement or group support and a 9 percent success rate among those using nicotine replacement alone. The Department of Public Health and Wellness and its community partners sponsor Cooper/ Clayton smoking cessation classes throughout the community. For a list of classes, visit www.louisvilleky.gov/. Your patients may also enroll in a class or get more information by calling 574-STOP (7867). Another smoking cessation program locally available is the Kentucky Quit Line. By calling 1-800-QUIT-NOW (1-800-784-8669), your patients can get free one-on-one help from smoking cessation coaches. An on-line version of the Kentucky Quit Line is also available at QuitNowKentucky.org. The on-line version also has a section for physician referrals. Healthy Louisville 2020 also recommends increasing smoking cessation services for expectant parents. Smoking during pregnancy is especially dangerous. It can cause birth defects, low birth weight and premature delivery. The 2014 Surgeon General’s Report now adds ectopic pregnancy, in which the embryo implants in the Fallopian tube or elsewhere outside the uterus, to the list of birth defects caused by maternal smoking during pregnancy. Ectopic pregnancy is very rarely a survivable condition for the fetus and is a potentially fatal condition for the mother. The 2014 report also finds that maternal smoking during early pregnancy can cause orofacial clefts in infants. After delivery, smoking in the home continues to be a major cause of Sudden Infant Death Syndrome (SIDS). Smoking cessation efforts, therefore, should focus on both parents and everyone else living in the home. QuitNowKentucky.org has a pregnancy and postpartum program. The Louisville Metro Department of Public Health and Wellness is also using the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPTS) Program in its Healthy Start home visitation case management program. The program provides comprehensive counseling to help pregnant woman quit or greatly curtail smoking during pregnancy and helps them establish a smoke-free home for the new baby. YOUTH SMOKING The 2014 Surgeon General’s Report asserts that more than 3.5 million middle and high school students in America smoke cigarettes. The vast majority (88 percent) of new smokers start smoking before age 18 and nearly all first use of cigarettes occurs before age 26. Policies to curtail the initiation of smoking among young people can significantly reduce tobacco’s toll on life and health in America in future years. Here in Louisville our young people are also taking up the tobacco habit in alarming numbers. During the 2011 – 2012 school years, 14.8 percent of Jefferson County Public Schools reported smoking within the past 30 days. Healthy Louisville 2020 advocates raising the state cigarette tax, which has proven to decrease smoking initiation among teens and pregnant women. Healthy Louisville 2020 also recommends reducing tobacco advertising, particularly in close proximity to schools and strengthening enforcement of existing laws prohibiting selling tobacco to minors. (continued on page 23) SEPTEMBER 2014 21