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VA New England Healthcare System


Great American Smokeout

Veteran points to his neck

Jean Larouche, Navy Veteran, pointing to scars on his neck from carotid stenting.

By John Paradis, VA New England Healthcare System
Monday, November 16, 2020

It’s hard to quit smoking. VA understands this.

The Veterans Health Administration can help anyone start the journey toward a smoke-free life.

Thursday, Nov. 19, 2020, is the Great American Smokeout, and the message to Veterans from the VA New England Healthcare System is that VA can help Veterans access the resources and one-on-one support needed to quit.

“There are a lot of options to help you quit,” said Jonathan “Johnny” Lee, a psychologist with VA Bedford Healthcare System’s Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass. Lee manages the smoking cessation program at VA Bedford and assists medical centers throughout VA New England with strategies to help Veterans kick the habit.

“Combining medication and counseling can triple your chances for success compared to going it alone,” Lee said. “You are not alone. We are here to help you every step of the way.”

Arthur Mullaney, a high school guidance counselor from Randolph, Mass., is credited as the Great American Smokeout’s founder. In 1970, Mullaney asked people to give up smoking for one day and donate the money they would have spent on cigarettes to a high school scholarship fund. In 1977, the American Cancer Society organized the first national Great American Smokeout.

The Smokeout occurs each year on the third Thursday of November. Smokers try to put out their cigarettes for the day with the attitude to “commit to quit” in the future.

Below are comments from Lee and Ariel Laudermith, a clinical psychologist and VA smoking cessation program manager at VA Central Western Massachusetts Healthcare System, about their approach in helping a person who smokes to quit.

Three Veterans who recently quit with their help gave permission to talk about their journey. They are Jean Larouche, a Navy Veteran from Granby, Mass.; Kimberly L. Merrill, an Army Veteran from Dover, N.H.; and Mike Neely, an Army Veteran from Marblehead, Mass.

All three smoked a pack-a-day or more and have had chronic health conditions due to a lifetime of smoking. But they quit the habit with VA help and credit VA’s smoking cessation program for removing tobacco from their lives and reducing their cancer risk.

The clinicians and Veterans recently described the important reasons to quit and how VA can help Veterans live a longer and smoke-free life. Here is a snapshot of our conversation.

Veteran who kicked the smoking habit

Kimberly Merrill, Army Veteran

What’s important about the approach the VA takes with smoke cessation?

Ariel Laudermith: It’s important to meet Veterans where they are in their journey of quitting smoking. The approach is to help increase motivation and increase confidence in Veterans that they have the ability to quit. We guide Veterans through evidence-based counseling for smoking cessation while also providing individualized care.  We also provide education about how tobacco effects physical and mental health so Veterans can make informed decisions.

Mike Neely: What got me was this COVID thing. Because with COVID you can’t breathe. You’re not getting enough oxygen. COVID got me to quit smoking. I quit in April. I would tell myself I am going to quit many, many times before. And I actually did quit many times. Then I’d start back up. You’ve got to want it more than anything other than life itself. For me, it was, “if I don’t quit, I am not going to stay alive.” What’s good about the VA program is that it is so multi-faceted. I told myself, I’m going to avail myself of every resource possible – well the VA just about offers every resource possible. The counseling, the prescriptions, the patches; they work with you. The important thing is to not stop trying. They will help you. A friend of mine, said, “you’re not a failure at anything until you stop trying.” And that’s the thing and the VA understands this – they work with you.

Johnny Lee: You don’t have to want to quit immediately when meeting with us. We want to help you develop a plan to give you the best chance for success and that means taking a carefully planned approach to quitting rather than just jumping in. Success is not due to willpower or luck. The average number of attempts it can take, according to data from the CDC (Centers for Disease Control and Prevention), is eight times before someone is successful for the long term. This is because we learn about what works and what doesn’t as we are going through the process. So, don’t quit quitting! I like what Mike said, you only fail if you stop trying.

Kimberly Merrill: The support that is offered is really important. I’m in a group with other Veterans that meets every Tuesday, and I look forward to it. And I get a lot of support from this group. It’s inspiring. There is maybe a half a dozen of us that meet. You got to have people to encourage you, whether it’s Dr. Lee or the Veterans I meet. And then for me, it’s been my church, my family and the VA. My faith has really helped. You can’t do this alone.

Veteran who kicked the smoking habit

Mike Neely, Army Veteran

Is there anything more you would like to emphasize?

Johnny Lee: This is part of an overall “whole health” team approach within VA that involves preventative health and all our clinicians. Based on results of a national survey of patients who receive care in the community, about 15% of patients say that they are offered help to quit smoking by their health care providers. In contrast, there is a national VA reminder for VA clinicians to ask their Veterans each year whether or not they use tobacco, to provide brief counseling, and to offer assistance in quitting. So, Veterans get asked this question every year. If you can think back to your annual primary care visits, do you remember getting asked about tobacco use?

Jean Larouche: The VA has been extremely supportive every step of the way. It’s important to have someone keep you on track and to go your own pace. Ariel is that little check and balance along the way. She’s the reality check. Because if I know I am going to see someone, I’m more motivated. Maybe it’s my ego, maybe it’s my pride, maybe it’s my competitive spirit. But I don’t want to go and say to her, “I had a cigarette.” I want to go and say, “hey, I’m still smoke free.” I need to know I am doing OK. I need that pat on the back. It’s always, “you’re doing OK; you’re right where you need to be.” And if not, she’ll tell me. I have to be held accountable. That’s important.

Ariel Laudermith: A lot of what I do is motivational interviewing. I’m a coach. Jean said at the beginning (appointment) when we first met, “I give myself a 50/50 chance.” That was our first conversation. So, to be the supportive person is what I do, and I’m glad to hear you say that Jean. The idea is for me and the Veteran to work together. It’s an individualized approach with every Veteran. I like to say, “slow and steady wins the race.” I’m not going to push anyone to go fast.

Mike Neely: It’s never too late to quit and stay quit.  When someone finds out they have cancer, you think, well what’s the point of quitting now?  When I was first diagnosed with cancer, the first thought that came to mind was, “what the hell, I went through all this crap not smoking and now I got cancer anyway, I might as well just smoke.”  That is that mental hook with the addiction – it will do whatever it can to get you back in.  But I’ve managed to remain tobacco free with the ongoing support from the VA, even after being diagnosed with esophageal cancer this past July, three months after I quit smoking.  So my hope is, that anyone out there that has to go through what I have to go through with cancer, please do whatever you need to do to stay smoke free.

Where can Veterans get more information?

Johnny Lee: You can go online to VA’s “How to Quit” page for more information. Veterans can ask their primary care team or any treatment provider for a referral for tobacco cessation. Every VA medical center in New England has a designated tobacco cessation lead clinician to ensure every Veteran gets all the resources he or she needs to quit.


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