The Cleveland Department of Public Health hopes advising residents to use nicotine patches, seek counseling and avoid social triggers will help reduce the city's smoking rate — currently one of the highest in the nation.
Those tips and others will be offered during a free seven-week smoking cessation course starting Wednesday. The course is one of several strategies the city is taking to reduce smoking in the city, said Katrese Minor, the department's director of Community Health Initiatives.
The city turned to free smoking cessation courses this past May as its efforts to reduce smoking by banning the sale of flavored tobacco products in Cleveland stalled in city council.
"Basically, one in three Cleveland adults — that's individuals 18 and up — use tobacco," Minor said. That's about three times the national smoking rate of 11.5%.
She said more than eight in 10 city residents live within a 10 minute walk from a tobacco retailer, and more than seven in 10 Cleveland public schools are within 1,000 feet of a tobacco retailer.
"So not only do we have a high prevalence rate of people using tobacco products, we have a very dense community where tobacco is readily available," Minor said. In Cleveland, which has a poverty rate above 30%, the high availability of tobacco can also exacerbate or contribute to health problems associated with poverty, health advocates have said.
Tobacco use is the leading cause of preventable disease, disability and death in the United States, according to the CDC. For every one person that dies of smoking, there are at least 30 people who live with serious smoking related illnesses.
"Smoking leads to disease and disability and it harms nearly every organ of the body," Minor said.
Advice for quitting
One key tip offered by the course is to use nicotine replacement therapies, such as over-the-counter nicotine patches and gums or prescription inhalers or nasal sprays.
"Nicotine replacement therapy usually improves [people's] success rate two to three times" compared to people who do not use the therapy, Minor said.
Facilitators also encourage attendees to use support groups or counseling when quitting tobacco products, she said. This can include Quitline, a number that connects callers with a smoking cessation coach, as well as hospital-based smoking cessation counseling programs.
The course also addresses issues such as stress management, maintaining motivation, avoiding weight gain, developing a new self-image and how to stay tobacco-free permanently.
Minor said the course will also advise people to start out with a reason for quitting and a way to do so.
"I do believe in that adage, if you fail to plan, you plan to fail," Minor said. "And it may take multiple tries, but the first step is one realizing why you want to do it."
Individuals who are struggling should keep in mind the significant health benefits involved, she said.
For example, according to Stanford Medicine, an individual's heart rate drops within minutes of quitting smoking, carbon monoxide levels in blood drop to levels of a non-smoker within a few days of quitting, coughing and shortness of breath decreases within a few months and risks from heart attacks and cancer drop within years of quitting.
Most challenging are the social aspects of tobacco use, she said.
"It becomes part of the fabric of your life," Minor said. "It becomes part of how you, you know, navigate the world."
She suggested changing routines so tobacco and smoking are not central to social interactions, she said.
"Maybe it's not taking breaks to have a smoke break," Minor said. "Maybe it's taking a break to go for a walk, to grab lunch or something. It's not easy because ... it's almost like breaking up with someone."
The course, developed by the American Lung Association, includes eight in-person group sessions facilitated by department staff. The first three sessions help attendees develop a individualized plan for quitting smoking, she said. The goal is for individuals to reduce their tobacco use over the next several weeks toward completely quitting use by the end of the program.
Cleveland plans to offer the program on a quarterly basis beginning in January 2025, Minor said, and attendees can take it as many times as they need to at no cost. Some people need as many as eight attempts before they quit successfully, she said.
Registration is available at the city's Tobacco Cessation Services site.
