Porter programs help residents quit tobacco products
MIDDLEBURY — Randy Bigelow in 1981 began smoking fancy Turkish cigarettes to get into the good graces of a young woman who enjoyed the same brand. He would move on from that romantic interest and consequently her expensive brand of cigarettes. He switched to less costly Marlboros.
Cheaper, but equally deadly and addictive. Early this past winter, Bigelow was smoking between three and four packs of cigarettes per day. Health consequences aside, the nasty habit was costing him around $150 per week.
Staring down the barrel of serious medical problems and potential financial ruin, Bigelow knew he needed to leave tobacco in his rearview mirror.
Easier said than done.
He had tried a smoking cessation drug called Chantix a few years ago, but stopped taking it when the pills didn’t quickly curb his addiction to nicotine.
He was skeptical about support groups, but was intrigued by an ad he saw for a Porter Medical Center smoking cessation course titled “A Fresh Start.”
“I wasn’t a fan of sitting in a group singing ‘Kumbaya,’” he said. “But I saw the ad and I said, ‘If I’m not going to do this by myself, I need to get together with a group. People behave differently when they’re in a group, and that was the key.”
So late last year he joined Porter’s five-week course, which will be known as the “Let’s Quit!” program when it resumes this August. Beginning the first Wednesday of each month, participants will meet for around five weekly sessions for 60 to 90 minutes under the leadership of a trained tobacco treatment specialist. The program assists anyone addicted to tobacco, whether they smoke or chew.
Participants are not judged and can come in with varying goals, whether it’s to scale back their tobacco consumption or kick the habit altogether. In addition to being given helpful tobacco cessation tips amidst others in the same boat, attendees can also access free medication and treatment to aid them in their quest to quit.
Bigelow decided this would be the time he’d send the Marlboro man riding off into the sunset. He again went on Chantix and, thanks to support from fellow “Fresh Start” participants and the tutelage of PMC Tobacco Treatment Specialist Jessica Stocker, he stopped smoking in January.
“There’s no impact when you break a promise to yourself, but there’s greater impact when you’re with a group and you make a commitment,” Bigelow said. “Then you are answerable to the group, and that’s a very strong bond.”
Porter officials said the new emphasis on tobacco cessation programming is part of a paradigm shift in the way health care is being provided in Vermont and nationally. It’s no longer in a hospital’s best financial interest to see a lot of patients needing acute medical care. Hospitals are now receiving incentives to keep their client population as healthy as possible.
That principle is ingrained in Vermont’s Blueprint for Health, a statewide effort to produce better health care services, a healthier population, and better control over medical care costs. Therefore hospitals like Porter have been ramping up programs and services to steer people away from bad habits and dietary pitfalls so they’re less likely to need expensive, invasive procedures and long hospital stays later in life.
“Imagine a world where the interests of our local health care system align perfectly with the interests of the community we serve,” said PMC President Dr. Fred Kniffin.
“Imagine a system of reimbursement which rewards Porter for working with our community to work with you to attain the best health possible. This is where we are heading. Porter is receiving a broadening amount of our revenue in fixed payments, creating ever increasing incentives to: focus on the health of our community; to invest in wellness; to align our organizational goals with the goal of our patients to be healthy.”
Ron Hallman, PMC spokesman, acknowledged the renewed focus on smoking cessation is also born out of a desire to help Porter employees. PMC is a smoke-free campus, though smokers have legally lit up on a public sidewalk in front of the hospital property.
Porter management received complaints from non-smokers about discarded cigarette butts and having to walk through tobacco smoke to get into the hospital. This prompted PMC to close that sidewalk-smoking loophole, but at the same time offer employees access to “Let’s Quit!” programming, including free nicotine replacement therapy.
“To make ‘population health’ work, we have to engage our patients out in the world where they live and work, providing support, education, and services that empower them to prevent new diseases, manage chronic diseases, and gain improvements in overall wellness,” said PMC Chief Medical Officer Dr. Carrie Wulfman.
“With teamwork and with patient engagement, and with more outpatient and transitional care management, Porter hopes to see our population become even healthier in the months and years ahead.”
Addison County already has a pretty good track record when it comes to public health.
According to the 2018 County Health Rankings & Roadmaps study produced by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute, only 13 percent of Addison County’s residents smoke. It has the second-fewest smokers out of the state’s 14 counties. The study also ranks Addison County first in the state in terms of average length of life and fewest premature deaths.
Porter has been offering community health programming since the late 1980s. But until recently, the programing didn’t always get the funding it needed, officials said. Porter temporarily eliminated its community health programing in 2012 due to a budget crunch.
“When times were tough, it was always on the chopping block,” Kniffin said.
But state and federal governments — along with Porter itself — are now making sure money is available to fund programs aimed at keeping patients healthy. PMC’s recent affiliation with University of Vermont Health Network has also helped greatly, according to Kniffin.
PMC is now spending around $750,000 annually on community health programming, most of it coming through a grant from the Vermont Blueprint for Health.
“We are really invested with our local community in making this a healthy place,” Kniffin said.
And it appears to be working.
Ana Macleod had been what she described as a “social smoker” for more than a decade. She could refrain from smoking for several days at a time and even through two pregnancies. But she always gave in to the temptation of smoking.
Last year, she decided she wanted to remain social — but without the smoking.
“I felt I had to make a change in my life, to have something to look forward to,” Macleod said.
She enrolled in “A Fresh Start” and, like Bigelow, emerged a non-smoker in January.
Macleod was candid in crediting Stocker and her classmates — and particularly Bigelow — for giving her the extra push to stop smoking.
“I needed someone there to motivate me,” she said.
And she got the nudge from a gregarious Bigelow, who during one class simply said “I did it, and I feel great.”
It resonated with Macleod, who told herself, “I’m going to win this time.”
Six months later, she’s still a winner.
Michele Butler is Porter’s Chronic Disease Self-Management Coordinator through the Vermont Blueprint for Health. She too pointed to the advantages of a group setting for those wanting to quit tobacco.
“The group is very powerful,” Butler said. “Some people don’t want to come to a group because they figure they should be able to quit on their own, with the (tobacco cessation) products out there. But there’s a lot of information you learn through the class in order to be successful.”
Bigelow is now relishing his newfound health.
“I never had difficulty breathing, but I had forgotten what it was like to have a full lung of air,” Bigelow said. “I’ve got much more stamina than I had before … and it just feels good to step outside and take a breath of air and enjoy it.”
Anyone wanting to learn more about, or enroll in, the free “Let’s Quit!” tobacco cessation program should email Michele Butler at email@example.com, or call 388-8860.
Reporter John Flowers is at firstname.lastname@example.org.
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