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Perinatal Nicotine Cessation

According to a recent review of maternal and infant wellbeing, “smoking in pregnancy constitutes the largest remediable risk factor for maternal and child health.”1 Because smoking is a risk factor that can be altered, cessation initiatives for those who are pregnant have the potential to positively impact both maternal and child health. Approximately 16% of women and birthing persons in the United States smokes tobacco2.

Obstetrical complications including placental abruption, fetal growth restriction, hemorrhage, and ectopic pregnancy are among the most common complications for birthing people during pregnancy. Pulmonary conditions such as asthma, birth defects of the mouth, increased irritability, bone fractures, breastfeeding difficulties, childhood obesity, and sudden unexpected infant death syndrome (SUIDS) are among the most common birth and health complications for children with nicotine exposure.1  Parents from lower socioeconomic backgrounds, who are unmarried or has a partner who smokes, who are heavy to moderate smokers, and who have a high school diploma or less are more likely to use nicotine during pregnancy. Those most likely to continue smoking during the postpartum period are parents who have exposure to second-hand smoke in the home, are formula feeding, did not intend to quit smoking long-term prior to pregnancy, have concerns about weight gain, and have stressors during pregnancy that worsen due to a lack of support.4

The American College of Obstetrics and Gynecology suggests that successful nicotine cessation strategies for those who are pregnant and postpartum will require providers to address these factors and the psychosocial stressors occurring during pregnancy and after birth.5 There is a myriad of stressors that can present for mothers and pregnant people that are specific to the perinatal period including circumstances of their pregnancy, risks for interpersonal violence, financial readiness to support a child, and status of parental leave benefits. Cessation programming and interventions that are specifically designed to support those who are pregnant in trying to quit nicotine must take these things into consideration.

We can improve perinatal nicotine cessation outcomes for moms, birthing people, and babies by doing the following:

  1. Engage in universal screening for nicotine and perinatal mental health conditions that co-occur in those who smoke, vape, or dip.
  2. Offer tangible resources that address psychosocial stressors.
  3. Connect parents with culturally responsive education and treatment options.

Let us work together to partner with organizations who can support this collective effort for the betterment of moms, birthing people, and babies in our community.

References:

  1. Gould, G. S., Havard, A., Lim, L. L., & Kumar, R. (2020). Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting. International Journal of Environmental Research and Public Health, 17(6), 2034. https://doi.org/10.3390/ijerph17062034
  2. Azagba, S., Manzione, L., Shan, L., & King, J. L. (2020). Trends in smoking during pregnancy by socioeconomic characteristics in the United States, 2010–2017. BMC Pregnancy and Childbirth, 20(1). https://doi.org/10.1186/s12884-020-2748-y
  3. Magee, S. R., Bublitz, M. H., Orazine, C. I., Brush, B., Salisbury, A. L., Niaura, R., & Stroud, L. R. (2014). The Relationship Between Maternal–Fetal Attachment and Cigarette Smoking Over Pregnancy. Maternal and Child Health Journal18(4), 1017–1022. https://doi.org/10.1007/s10995-013-1330-x
  4. Levine, M. D., Cheng, Y., Marcus, M. D., & Kalarchian, M. A. (2012). Relapse to Smoking and Postpartum Weight Retention Among Women Who Quit Smoking During Pregnancy. Obesity, 20(2), 457–459. https://doi.org/10.1038/oby.2011.334
  5. American College of Obstetricians and Gynecologists. (2020). Tobacco and nicotine cessation during pregnancy. ACOG Committee Opinion No. 807. Obstetrical Gynecology, 135, e221–9.
2023-06-05T08:43:29-04:00June 5th, 2023|Dr. Alfred|

School’s Out for Summer

Schools have pretty much wrapped up this school year. Seniors have graduated and elementary students have had their field day. For some youth, summer is a great time to have a part-time job, vacation with their family, or simply enjoy the warm summer days.  Some of our kids will find it a challenge to feed their nicotine addiction away from the school hallways and bathrooms. So, what are we as parents and caregivers supposed to do?  Here are several tips that your child might be vaping.

Have they started becoming more secretive and closing their door more often? This is certainly normal adolescent behavior so each parent or caregiver will have to establish what is normal for their child.   Maybe they are making a lot of excuses to use the restroom or go outdoors. Does their room have a sweet smell and are they using candles or room fresheners to disguise a smell? How about physically, is there a change in their sleeping, or have they developed a raspy cough or have lung infections? Maybe you will see a change in eating habits or having nausea.  The last one, are they more irritable, have more mood swings, or are they anxious.  This could be a sign that they are vaping.

I cannot leave us at just identifying if our child is vaping, I must share several next steps if you believe they may be vaping. First, talk to them. Come to this conversation with concern, not judgment. Listen more than you talk.  Help them develop a plan as to how they can quit. You might want to include their physician in this conversation.  For additional resources, check out Parents Against Vaping E-cigarettes.   https://www.parentsagainstvaping.org/

2023-06-05T08:42:04-04:00June 5th, 2023|Bruce Barcelo|

World Tobacco Day is May 31st!

World No Tobacco Day is this month. On May 31st, schools, healthcare professionals, and public health champions from around the world will join together to raise awareness about the devastating impact tobacco products have on our health and our environment. Typically, youth are not moved by numbers, but these may perk their ears up just a bit. Tobacco kills up to half of its users and more specifically, more than 8 million people each year. Over 7 million of those deaths are the result of using a tobacco product while 1.2 million are the result of non-smokers being exposed to second-hand smoke.

What does interest them are environmental concerns. Here is my “Bruce’s Best” for May. Talk about the environmental impact of tobacco.

  • Scarce available land and water are being used for tobacco cultivation with thousands of hectares of timber being destroyed for tobacco production.
  • 766,571 metric tons of cigarette butts make their way into the environment every year.
  • If you put cigarette litter waste “butt to butt”, it would wrap around the earth 3 times!
  • Vapes create major plastics environmental waste, tech waste, and introduction of toxic chemicals into the environment.

Help our youth find their voice and become advocates for issues that will change the world.

2023-05-02T15:04:25-04:00May 2nd, 2023|Bruce Barcelo|

Maternal Mental Health and Nicotine Cessation

May is Mental Health Awareness Month and for this newsletter, we would like to highlight the importance of promoting maternal mental health for nicotine cessation. According to recent data from the Pregnancy Risk Assessment Monitoring System, about 50% of women who smoked cigarettes prior to pregnancy continued to smoke during pregnancy.1 Additionally, an estimated 1 in 10 pregnant women smoke during the last trimester of pregnancy.2 An important context to consider is that many people who are pregnant or new parents experience stressors and mental health complications, including depression, anxiety, and trauma that may contribute to unhealthy coping, including nicotine use.3 Parents with lower economic resources, and who were also depressed, are at increased risk for smoking during pregnancy and have a lower likelihood of quitting.1 For mothers and parents who experience emotional and psychological challenges and are trying to quit nicotine without adequate support and resources, the consequences can potentially impact the entire family.

Those of us who work in nicotine treatment understand that the desire to quit does not always translate into immediate behavioral modification. As a psychologist who works in maternal mental health, I advocate that all moms and birthing people have access to individual or group therapy, medication as needed, peer support, and other mental health resources. There are so many life circumstances that make pregnancy and early parenting challenging and there is a need for adequate emotional support. However, mental health resources are not adequate for changing the landscape of maternal mental health, especially as it relates to nicotine treatment.

Support for new parents who have mental health complications or diagnoses and who are also trying to stop using nicotine products requires the use of a systemic approach. In addition to offering nicotine education and mental health resources, it is important for us to understand the unique basic needs of each person we treat. Where there is a lack of basic necessities (e.g., food, housing, finances), an effort must be made to meet these needs. Where there are challenges with life stressors, we must work to help parents find solutions that work for them. These considerations are essential to sustain nicotine cessation initiatives. So, our charge this month is to expand our conceptualization of effective, long-term nicotine treatment interventions, to include, but not be limited to mental health resources and support when needed.

 

References:

  1. Allen, A. M., Jung, A. M., Lemieux, A., Alexander, A. C., Allen, S. S., Ward, K. D., & Al’Absi, M. (2019). Stressful life events are associated with perinatal cigarette smoking. Preventive Medicine118, 264–271. https://doi.org/10.1016/j.ypmed.2018.11.012
  2. Tong, V. T., Farr, S. L., Bombard, J. M., DʼAngelo, D., Ko, J. Y., & England, L. J. (2016). Smoking Before and During Pregnancy Among Women Reporting Depression or Anxiety. Obstetrics & Gynecology128(3), 562–570. https://doi.org/10.1097/aog.0000000000001595
  3. Jones, A. R., Carter-Harris, L., Stiffler, D., Macy, J. T., Staten, L. K., & Shieh, C. (2020b). Smoking Status and Symptoms of Depression During and After Pregnancy Among Low-Income Women. Journal of Obstetric, Gynecologic, & Neonatal Nursing49(4), 361–372. https://doi.org/10.1016/j.jogn.2020.05.006
2023-05-03T14:36:53-04:00May 2nd, 2023|Dr. Alfred|

Welcome New Board Members!

We’re excited to announce that we have added three new board members to our team, Dr. Roy St. John, JoAnn Reilly and Dennis Smith!

Dr. Roy St. John is a pulmonologist as well as the new Chief Medical Officer of The Breathing association. St. John also the medical director and principal investigator at Centricity Research and Aventiv Research. His research includes numerous Phase 2, 3 and 4 pharmaceutical studies.

Dr. Roy St. John’s Why: “As a pulmonary physician, I have had the opportunity to work in a variety of settings caring for patients with the full spectrum of lung diseases. In addition, for the last 9 years I have worked for Centricity Research and Dr. Samir Arora. He is the person who connected me with The Breathing Association last year, which led to my recent appointment as the Chief Medical Officer, and subsequently, becoming a member of the Board of Directors. I am very grateful to be joining this wonderful organization and look forward to working with such a caring team.” 

JoAnn Reilly is the Senior Advisor of Pegasus Marketing Services. She specializes in achieving marketing goals and outreach success in healthcare related products, services, and delivery for faith-based organizations.

JoAnn’s Why: “I have known Lori Sontag, TBA President and CEO for many years, and admire and respect her passion for health care.  As she described the history and services provided within TBA, I was immediately intrigued.  The critically important work done at TBA resonated with me as I reflected back on my own family and work community who have been afflicted with breathing conditions.  Additionally, COVID has illuminated the severity of breathing related health issues.  It is an honor and privilege to play a small role in supporting a growing organization that provides invaluable education and services to people affected by breathing challenges.”

Dennis Smith is Principal Owner at DJS Consulting Services. He specializes in administrative management, board communications, budgeting and forecasting, community relations and more.

Dennis’s Why: “Through a mutual friend I was fortunate to meet Lori Sontag and learn about the Mission and Vision of The Breathing Association. I was looking for an opportunity to contribute what I can to a worthy and needed nonprofit in the Columbus vicinity and without a doubt I felt this was that organization. I am honored to have been considered for a seat on the board.”

2023-05-02T15:34:55-04:00April 24th, 2023|New Board Members|

Visit The Breathing Association at this year’s Urban One Health and Fitness Expo April 29th!

Did you know that seven out of ten people want to quit smoking, but do not know where to start? On Saturday, April 29 from 10am – 3pm, The Breathing Association will be attending the Urban One Health and Fitness Expo to offer free tobacco cessation information and resources.

Our very own Chief Operations Officer/VP of Operations, Iyaad M Hasan, DNP, MBA, APRN, will be at the expo to help educate participants about smoking cessation and answers your questions about why you should quit, how to quit and what treatment options are available to you.

The Urban One Health and Fitness Expo will be located at St. Stephen’s Community House 1500 East 17th Avenue Columbus, OH 43219.

For more information and details on this event, checkout the link below!

Click here for more information
2023-04-07T16:26:37-04:00April 7th, 2023|Events|

Tobacco Litter: Why It Matters

When you have the opportunity to talk with youth about using nicotine products, please don’t waste your time overwhelming them with facts about how it will harm their health and how addictive they are. Is that what I’m most concerned about? Absolutely! But it’s not what they are concerned with, and you will lose them in a heartbeat. So, what will they listen to? They will listen to the fact that Big Tobacco is concerned with one thing, profit. They have always considered youth as replacements for most customers that will become sick and die prematurely from using their products. When we show them the predatory advertising and marketing of the tobacco and vaping industry, youth don’t like being played.

Youth also cares about environmental issues. Tobacco and vaping are the largest forms of single-use plastic global environmental threats. Every minute, people dispose of 8.5 million cigarette butts. That is enough to fill an Olympic-sized swimming pool in under an hour. Cigarette butts leach nicotine and other chemicals that harm or kill aquatic life. Micro-plastics have been found in water, in the air, and even in human organs and breast milk.

E-cigarette waste is potentially a more serious environmental threat than cigarette butts since e-cigarettes introduce plastic, nicotine salts, heavy metals, lead, mercury, and flammable lithium-ion batteries into waterways, soil, and to wildlife. Unlike cigarette butts, e-cigarette waste won’t biodegrade even under severe conditions. E-cigarettes left on the street eventually break down into micro-plastics and chemicals that flow into the storm drains to pollute our waterways and wildlife. There are many good resources for information on the environmental impact of tobacco products, check out Parents Against Vaping E-cigarettes, “Vapes are Trash”: https://www.parentsagainstvaping.org/vapesaretrash

Standing up against big industries that use slave labor, pollute our planet, and use predatory advertising to addict individuals is cool. Giving your money to Big Tobacco, which is interested in only making profits and harm our environment is…(I ask them to tell me how smart it is.)

2023-04-04T10:43:10-04:00April 4th, 2023|Bruce Barcelo|

This Mother’s Day, help others breathe easier.

Starting April 1st through May 9th, you can purchase a plant from Thorsen’s Greenhouse and a portion of the proceeds will go to The Breathing Association’s Lung Health Clinic. The very first Mother’s Day in Ohio was celebrated because of the tireless work of our founder, Carrie Nelson Black. In 1911, she prevailed upon Governor Judson Harmon to issue the state’s first Mother’s Day Proclamation, and we’ve honored moms on this day ever since.

In recognition of Carrie Nelson Black, The Breathing Association has partnered with Thorsen’s Greenhouse to raise funds so that we can expand the number of individuals and families we reach. There would be no fresh air without plants, and a Mother’s Day gift from Thorsen’s not only celebrates the mom in your life, it also brings lung charity health care to those in need.

To purchase a Mother’s Day gift, go to Thorsen’s Greenhouse and enter promo code “breathe” at checkout, and a portion of the proceeds will be donated to The Breathing Association. To send a personal message with your gift, type your message under “Notes” at checkout.

Click here to purchase
2023-03-28T16:47:40-04:00March 28th, 2023|Uncategorized|

Highlighting Black Maternal Health Week: Our Bodies Belong to Us

Black Maternal Health Week is April 11-17, 2023, and this this year’s theme is “Our Bodies Belong to Us: Restoring Black Autonomy and Joy.” The ability of Black moms and birthing people to make decisions about our bodies and our health is essential to how we manage all health behaviors and achieve overall wellness. With rising rates of maternal and infant mortality in the Black community, including in Ohio, there is a need to create systems of care that center Mamas’ autonomy and the right to choose care options that align with their cultural beliefs and practices.

The Black Mamas Matter Alliance highlights culturally congruent practices, including access to Black midwifery and Black-led doula care as primary needs for Black mamas and birthing people. Black midwifery and Black-led doulas center Black mothers and babies. By design, they have an inherent understanding of Black bodies and our cultural contexts, they focus on non-medicalized births when possible, and they create environments of active listening and attending to mothers’ needs during pregnancy, birth, and early parenting.

The latter tenet of care translates to other forms health promotion, including nicotine cessation. It suggests the use of comprehensive, culturally congruent models of care that consider a person’s whole life experience.  If for example, a person’s basic needs are unmet, quitting smoking or vaping will be difficult especially if stress is a trigger for use. For Black mamas and parents who are also managing racism- or other trauma-related stressors, but do not have adequate support or resources, quitting will be challenging. Whatever the factors that impact a parent’s ability to quit nicotine must be addressed if they are going to be successful at quitting. As such, we must listen to Black moms and birthing people and respond accordingly.

As providers, we have a wealth of knowledge in regard to our respective disciplines. Many of us have licenses, certifications, and advanced training in our fields. Despite the knowledge we have about health behavior, risks, benefits, and the most effective treatment options, Black women and birthing people are the experts on our bodies and lived experience. As care providers we need to honor that, understand that, and prioritize care that is centered on that. Our bodies belong to us, and we will care for them based on our values, beliefs, and the knowledge we acquire from our providers in making informed decisions.

As you ponder changes you will make in your practice to re-empower Black moms and birthing people to practice autonomy with their health decisions, consider supporting and uplifting Black-owned and led organizations in our community that support birth equity, reproductive justice, and maternal mental health awareness for Black moms and birthing people. The organizations listed below are both local and national organizations that focus on Black maternal health. Support them.

Resources:

https://www.roottrj.org/

https://mhaohio.org/poem-rise/

https://blackmamasmatter.org/2023-black-maternal-health-week/

https://www.shadesofblueproject.org/

2023-03-28T08:22:56-04:00March 28th, 2023|Dr. Alfred|

Dr. Thomas Houston announces retirement after 15 years of service

Dr. Thomas Houston, Medical Director of The Breathing Association’s Lung Health Clinic and as Tobacco Cessation Training Course, has announced his retirement.

Dr. Houston has an impressive bio as a graduate of the University of Mississippi School of Medicine. After a 10-year career in academic family medicine, he directed the American Medical Association’s tobacco control and public health advocacy programs. From 2003 to 2005, he held the Jim Finks Chair in Health Promotion at Louisiana State University Health Sciences Center in New Orleans and was Professor of Public Health and Family Medicine. From 2005 to 2016, he worked at the McConnell Heart Health Center in Columbus, where he directed tobacco cessation and policy initiatives for OhioHealth. He was a former president of the Ohio Academy of Family Physicians, and he is currently Adjunct Professor in the Department of Family Medicine at The Ohio State University.

As impressive as his bio is, it does not signify just how much of his life has been donated to helping those around become better people. He has spoken up for those who could not speak for themselves as an advocate of tobacco cessation, and he implemented the Tobacco Treatment Specialist Program for The Breathing Association to help medical professionals, counselors, and therapists educate others in becoming tobacco free.

Dr. Houston has served as a board member and Medical Director of the Lung Health Clinic since 2008. The Breathing Association is a richer organization thanks to Dr. Houston’s service over the past 15 years. He has left a legacy that time cannot diminish.

2023-03-28T14:16:54-04:00March 17th, 2023|Uncategorized|
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