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Statistics related to tobacco use in the United States are almost incomprehensible: 50 million users. $350 billion in health care costs. More than 480,000 people die each year. Unfortunately, those numbers are climbing.
Similar to diabetes, cancer, obesity and mental health, tobacco use is a lifelong disease. If health care providers were empowered to treat it this way, they could improve the lives of millions of Americans and prevent deaths.
To do this, tobacco must be the primary prevention service focus for all stakeholders: physicians, patients, health plans, employers. One in five people entering their next primary care visit is affected by tobacco use. Most of them want to quit smoking, but we still lack collective programs and motivational pathways to help them.
Tobacco users today: more than just cigarettes
The FDA classifies tobacco into the following four categories:
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Combustibles such as cigarettes, cigars, pipes, roll-your-own cigarettes and hookahs;
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Electronic nicotine delivery systems, including e-cigarettes, e-cigarettes, cartridges, cartridges, self-mixing and heat-not-burn products;
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Smokeless products, including chews, snuff, and pouches;
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New and future products, including solubles, nicotine gels, sachets and other previously unregulated items.
Primary care providers are proficient in the management of chronic treatable diseases.
“You should stop!” does not apply to obesity, mental health, or any other chronic disease, nor does it stop smoking.
Smoking, vaping and any other form of tobacco use must be dealt with on an ongoing basis. Smoking cessation can reduce the incidence of major coronary events by more than 50%, reduce stress, reduce back pain, and improve outcomes and outcomes for cancer patients. Providing behavioral science-based solutions can significantly reduce health risks, not to mention financial costs.
Healthcare Provider = Superhero
So why are healthcare providers best positioned to defeat tobacco? On the one hand, most users have seen someone who can help them — in 2020, 85% of adults saw a healthcare professional.
Doctors are also influential: Thanks to them, we have achieved such high success rates with colonoscopies, flu shots, and other preventive services. (While half of the eligible U.S. population is vaccinated against influenza and 67% screened for colorectal cancer, less than 1% of tobacco users are enrolled in a health plan or employer-provided smoking cessation program.)
Empowering healthcare providers includes making it easy for them to click and help patients at the point of care. Behavior change therapy requires an ongoing relationship with a professional, and virtual therapy makes this more accessible. Telemedicine, apps, and other tools help create a clear path to quitting — just as patients use continuous glucose monitoring to monitor diabetes or Fitbits, or tools such as breath sensors help provide users with the science and motivation to quit smoking permanently.
It’s now
Tobacco use has increased in the Covid era, with more cigarette sales and fewer people seeking help to quit. In 2020, tobacco-related deaths were almost three times higher than Covid deaths.
Not only is tobacco the country’s largest cause of preventable deaths and health care claims, such as poverty and diabetes, it also disproportionately harms those most affected by health inequalities. It affects spouses, children and thousands of people who do not use tobacco themselves: In 2020, 60,000 tobacco-related deaths in the United States were caused by secondhand smoke.
Half of all cigarette users try to quit smoking alone each year, but only about 1% are successful.Like health experts have been talking about “harm reduction” and seeing drug addiction as chronicit is time to rethink how we view and treat tobacco users.
go ahead, smoke free
10% of U.S. health care costs are attributable to tobacco use. If a system, company, or health plan doesn’t make tobacco a top priority for preventive services, it ignores the most important way to reduce preventable deaths and health care costs.
Getting patients to quit smoking and remain smoke-free requires ongoing, customized, flexible, easy-to-use, and user-free treatments. Through collective efforts and seeing tobacco use as an appropriate tool for chronic disease, we can spark a wave of positive change.
Now is the time for primary care physicians to blaze the trail.
