A new beginning

It is a meeting that begins with introductions, almost as if everyone’s new.

“Hi, my name is Mona, and I feel very good today. I can taste my food now, and I can breathe better.”

And then someone reveals a happily kept secret.

“I haven’t smoked since our meeting last week,” says Mona, with a smile.

A round of applause circles the table, and the feeling of anonymity vanishes. A feeling of support fills the room, and Mona blushes with the attention. She and nine of her peers are sitting in a room at New Beginnings, a clubhouse in Dartmouth that provides ongoing support for adults living with long-term mental illnesses. They are talking about how their goals for the program are coming along.

In December 2008, New Beginnings began its second stop smoking program titled Butt Out for Better Health. Offered by Capital Health’s Addiction Prevention and Treatment Services (APTS) , the program is designed specifically to help individuals living with mental illness to break their addiction to nicotine.

Dion Thomas-Hodges, a community outreach worker with APTS, explains that Capital Health began this targeted program in 2007. The existing public, tobacco intervention program offered by APTS simply wasn’t meeting the needs of individuals living with mental illness.

“Their smoking prevalence rate is a lot higher than the general public’s,” says Dion. “And they’re a high-risk group to work with because they’re dealing with mental illness at the same time.”

Butting out for health

The first Butt Out for Better Health program ran from April 2007 to May 2008. This year there is an additional program offered at Connections in Halifax. Both programs offer a weekly support group to help participants who are concerned with their tobacco use or who want help to stop using tobacco products.

The meetings begin with a carbon monoxide test – it measures how much carbon monoxide is in a person’s system – and follows with a peer discussion about how the quitting process is going. Dion leads the group discussion, which includes basic education on tobacco use. Each participant takes different forms of Nicotine Replacement Therapy (NRT) – the patch, gum, lozenges, or inhalers – to help them. All of the NRTs are free and provided at each meeting.

This is not a typical tobacco intervention program. The first difference is the length of the program. Butt Out for Better Health is open and ongoing throughout the year. The general public program is four weeks and closed. Dion says the four-week program simply wasn’t working for people with mental illness.

The second consideration is medication. Dion says nicotine from tobacco products interferes with many medications and can reduce their effectiveness. Nicotine can also lessen the side effects of certain medications. This can make using tobacco products a positive activity for some people.

The risks associated with using tobacco products are clear. Tobacco use causes or contributes to a variety of physical illnesses including cancer, emphysema and a possible early death.

It is also expensive. Money spent on cigarettes is money that is not not available for food or bills. Dion helps people understand that, in addition to being a healthy way to live, a life without using tobacco products can have other perks. Saving money can be one of them.

Finding a way

John Leahy, a participant in both the first and second New Beginnings Butt Out program, says he wants cigarettes out of his life – for good.

“It’s a little cycle of people like us with disabilities,” says John. “We spend most of our money on addictions instead of being healthy.”

John lives with depression, some of which is seasonal. He smoked his first cigarette at age12 or 13, and started smoking regularly at age 19. Before the first program in 2007, John was smoking between half to more than a full pack of cigarettes. He has cut down significantly – he averages about eight cigarettes a day, and is aiming for less. He hopes to quit by the end of this second program. He uses all of the NRTs offered, usually as he needs them.

“Sometimes I don’t reach for them when I should, and I get to the point where I don’t have enough nicotine in my system,” John admits. He adds that he’s also cutting back on his coffee intake. His old coffee-and-cigarette habit doesn’t work, so he’s cutting out both.

Another tactic John is using is to generally stay away from people who smoke. He finds the smell bothers him much more than it used to, and it makes him feel sick.

“It stinks! It turns me off, and I notice it a lot more now this time,” says John.

A champion

Joyce says she enjoys a happy, healthy life without cigarettes.

When participants in the Butt Out program step into the meeting room each Thursday, they have something – or someone – to look to for inspiration: Joyce, a champion of the program for people who live with mental illness. Joyce lives with a mental illness. four years ago, she stopped using tobacco products. A nurse gave her a cigarette as a Christmas present, and she smoked half of it before she decided it was time. She just knew she was ready to quit. Joyce says she enjoys a happy, healthy life without cigarettes. She hopes to support everyone in the Butt Out program to do the same.

“You’ll know when you don’t want it,” she says.