It’s no secret that smoking is an addiction that plagues many Americans. According to the Centers for Disease Control and Prevention, approximately 34.2 million individuals over the age of 18 smoke cigarettes on a regular basis.
“Nicotine is one of the most highly addictive substances known to man,” says Raiza Schreiber, a clinical nurse at the Tobacco Treatment Clinic at Johns Hopkins Bayview Medical Center in East Baltimore. “In fact, it’s the only substance that switches normal neurotransmitters in the brain into nicotine receptors. That means for someone who is addicted to nicotine, there is brain-signaling to their body that they need nicotine. It’s a chemical imbalance.”
That imbalance makes it challenging, but not impossible, to quit smoking. And helping people quit is exactly what Schreiber does through her position at the Tobacco Treatment Clinic.
“Tobacco cessation is for any type of tobacco users and includes cigarettes, cigars, e-cigarettes and vaping,” she says. “At the clinic, we treat patients with any kind of nicotine or tobacco habit who are looking to quit. We’ve had patients join the clinic smoke-free who want help preventing relapse all the way to heavy smokers. The clinic as a whole is geared toward helping and enabling patients to quit in a practical and supportive way.”
A first of its kind in the state of Maryland, the Tobacco Treatment Clinic is staffed by a team of doctors and nurses, led by Dr. Panagis Galiatsatos. Since its start in 2018, the clinical team has treated more than 200 patients.
“I became a nurse to help patients and to be able to provide them with tools and education they need to help themselves,” says Schreiber, a member of Kol Torah Synagogue in Northwest Baltimore. “Most of my patients are tired and aggravated with smoking and so badly want to quit. They are motivated and determined. For me, to have the opportunity to help them on their journey is gratifying and fulfilling.”
Patients begin their journey at the two-year clinic with an initial intake session at which they go over their entire smoking history with Dr. Galiatsatos, including how their body breaks down and metabolizes nicotine.
The first year of the clinic is focused on quitting smoking and the second year concentrates on continual communication and support to prevent relapse. The personalized approach is the key to the patients’ success.
“The clinic is geared toward enabling patients to quit smoking in a practical and supported manner,” says Schreiber. “If you are diagnosed with diabetes, the doctor doesn’t tell you to fix your insulin intake and come back when you’re better. The same is needed with tobacco or nicotine addiction. Patients need medical care when they are trying to quit. That care includes medication, support, education and constant touch points.”
One of Schreiber’s main roles at the clinic is to educate patients on how to use medications that are proven to help with smoking cessation.
“Most people don’t know how to use relievers like nicotine gum, lozenges, patches and spray,” she says. “A lot of people that complain nicotine gum makes them feel sick or that patches don’t work. These medications take a few months to kick in before a patient will see any changes, but most people only give them a few weeks.
“Part of what we do is track their medications, check in and follow up with patients to make sure everything is being used correctly.”
It’s the touch points and education that make the Tobacco Treatment Clinic’s approach to quitting smoking unique.
“The constant touch points are what makes this clinic successful,” says Schreiber, who calls between six and 12 patients weekly. “The touch points aren’t meant to be a reminder for them to stay on track. Instead, it’s a support system where we offer a lot of encouragement to our patients who are struggling to see the successes they are having. I have a lot of patients who are so hard on themselves, and I try to remind them how great they are doing. Helping them recognize their own successes and giving them hope is a big part of what makes this all work.”
Schreiber says she hopes to start a virtual support group for patients to connect with one another because with the coronavirus pandemic, those touch points are more necessary than ever.
“When COVID-19 first broke out, I called all our patients and reminded them to cut themselves some slack during the quarantine,” says Schreiber, who started seeing patients virtually during the lockdown. “We know the two biggest triggers for smoking are stress and boredom. The quarantine was both of those things. I reminded patients they may have small setbacks and that’s all right. We all had to focus on our mental and physical health, and that the most important thing was they were keeping themselves safe.
“In terms of smoking, throughout this time, I’ve been impressed with all our patients who are incredibly strong and dedicated to their journey.”
For information, visit hopkinsmedicine.org/pulmonary/patient-care/tobacco-treatment-clinic.html.