Efforts to encourage people to quit tobacco remain a priority for Cochise County and the state, even though cigarette smoking has reached an all-time low.

Over 480,000 people die annually in the United States because of tobacco use, according to the Centers for Disease Control and Prevention. About 14 percent of the U.S., or about 34 million of the adult population, are smokers.

The county’s tobacco prevention services department is committed to providing community education and support for those who are trying to quit. They partner with national and state agencies to provide that assistance.

Suzanne Hagle, Health Promotion Administrative Manager, said that about 21 percent of adults in the county are tobacco users. She said that due to the nature of nicotine in the products, tobacco can be very difficult for people to kick.

“It’s an addiction, so it’s hard to quit,” she said. “Most try several times before they really quit and often something happens in their life where they might relapse hard that way.”

“From what we understand, most smokers don’t actually want to be smokers.”

While the county doesn’t offer any local community cessation classes, they do a lot of outreach and direct people to several online programs.

“We do offer community presentations to adults and school-aged kids,” she said. “We also partner with the Arizona Smokers Helpline — ASHline,” Hagle said.

“If we come across people who want to quit we refer them to ASHLine who do phone-based counseling and offer two-weeks quit nicotine replacement therapy.”

ASHLine is a state program started in 1995 that helps people quit through free phone and online coaching.

The program is run out of Mel and Enid Zuckerman College of Public Health at the University of Arizona.

Assistant director Uma Nair has been working with ASHLine for about 4 years, but has been researching and working with nicotine dependence for more than 12 years.

She said that the goal with phone coaching is to set a quit date and provide tools to clients for success. They work with clients based on what might work best for each individual and also provide two weeks of nicotine replacement therapy products regardless of a person’s insurance.

“We use evidence-based cognitive therapy and interviewing, not full-blown cognitive therapy because we must be succinct, but elements of it combined with motivation,” Nair said. “If someone says ‘I want to quit tomorrow,’ we will provide guidance and increase their confidence.”

“We work with them and meet the client where they are at to make sure services are most aligned to their needs.”

Those who want to end their tobacco use can get matched with a quit coach on ASHLine who will help create a customized quit plan for the client.

Typically, quit coaching includes about seven calls in about 12 weeks on average, but can go for longer for someone needs it. They also offer texting services.

Nair said that one of the major barriers in quitting for many smokers is stress management.

“Many people who smoke are lower income and they have stress in their life,” she said. “The demographic of smokers has changed so drastically, and a large percent of them have a lot of stress.”

“It’s a habit; the typical age of a caller is 45-50 and they’ve been smoking since 20, so that’s 30 years of addiction we’re trying to work with.”

There are many methods for quitting tobacco including nicotine patches, nicotine gum, self-help books, therapy, medication, stopping cold turkey and more.

One tobacco cessation method that has become popular in more recent years is vaping.

Vaping as a nicotine reduction or cessation method has mixed research and opinions.

Local photographer Robert Gallucci is a recent nonsmoker. He said he started at 10, and has quit and started again several times in his life. Switching to vaping helped him reduce his use of tobacco products, but he said vaping was the hardest addiction to break.

“There is no question it helped me give up cigars and my pipe — I was smoking at least a cigar a day and was able to stop,” he said. “But vaping delivers a pure shot of nicotine into the system.”

“I very quickly became addicted to it and consumed more nicotine than I ever had with tobacco products.”

Since quitting, he said he can breathe better and is experiencing a number of benefits.

“According to my expert on the matter, my wife, I experienced dramatic mood swings while vaping,” he said. “She also says that I am sleeping better and, of course, there is the financial savings.”

Nair said that when it comes to vaping, ASHLine provides the information they have on its health impacts to clients and if someone is hoping to reduce their tobacco use through vaping, they won’t discourage them.

“The science on e-cigs is murky with some studies saying it works and others that it doesn’t,” she said. “What does the client want to do? If they say ‘I want to keep smoking e-cigs,’ it’s safer, but still nicotine.”

Hagle said the county has included information on vaping into their educational programming.

“We have put presentations together that have been sent to the Arizona Department of Health Services,” she said. “Teachers and parents most of the time are not aware of paraphernalia because they look like writing pins or zip drives so they aren’t even aware its a vaping device.”

Though it’s a difficult task, there are a number of both physical and mental benefits to quitting tobacco. Gallucci encouraged people to stick with it when they try quitting.

“Once you quit, do everything in your power to stay quit and don’t lie to yourself,” he said. “You are never more than one smoke away from being right back where you were.”

For more information on the county’s tobacco prevention efforts, visit www.cochise.az.gov/health-and-social-services/tobacco-prevention-services.

To learn more about ASHLine or to start your quit plan, visit https://ashline.org.

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