This occasional series highlights some of the practice areas where tobacco treatment specialists (TTS) work and offers tips for treating tobacco use within a specific population. In this post we hear firsthand from Eiman Newcomer, the Clinical Team Lead for the UNC Tobacco Treatment Program.
I have been a Tobacco Treatment Specialist (TTS) at UNC for five years and continue to feel fulfilled by the assistance I am able to offer patients during a difficult time in their lives. Inpatient tobacco treatment provides me and my team with a unique opportunity to make a significant impact throughout a patient’s stay. Through a single, brief conversation, we are able to increase patient comfort and provide a judgement-free space for patients to explore their personal thoughts and goals regarding tobacco use and their health.
When patients are admitted to the hospital, they often experience nicotine withdrawal, which can appear in the form of anxiety, irritability, headaches, and cravings. The goal of a TTS is to help manage these symptoms to allow patients to focus on their healing. We also aim to increase a patient’s understanding of whether their tobacco use aligns with their long-term goals. Our visits with patients take place at the bedside, but since the pandemic they are now completed by phone and range anywhere between 10-20 minutes.
I have observed that patients who are hospitalized are more receptive to these conversations as they are often more motivated to make healthy lifestyle changes to reduce risk of readmission. This is a prime opportunity for patients to develop alternate coping skills in a tobacco-free setting.
Visits typically begin with the TTS assessing for withdrawal and gathering information on the patient’s tobacco use history. I find that once patients realize we are not there to lecture them on the importance of quitting, they become more comfortable sharing details about their use. We utilize motivational interviewing techniques to explore a patient’s motivation to change and evoke their readiness to do so. Through our training, we are taught how to roll with resistance and support a patient’s right to self-determination. This involves respecting where patients stand regarding their motivation to reduce or stop tobacco use. Ultimately, the patient is responsible for choosing and carrying out personal change, while our goal is to elicit and explore their own arguments for change. One way that we do this is by building awareness and highlighting the difference between someone’s current tobacco use and their desired outcomes.
Most patients recognize that ongoing use would take them further away from their sought-after goals, whether that be improved health and finances or more time with loved ones. The remainder of the visit includes exploring specific strategies patients can implement to assist with urges and triggers, as well as providing psychoeducation on how cessation or reduction of use can aid in their healing process. Our team provides recommendations for nicotine replacement therapy (NRT) and works alongside providers to ensure patients receive NRT both while inpatient and at discharge to assist with managing cravings and reducing discomfort. We also provide options for follow-up support, including referral to the North Carolina Quitline and our outpatient tobacco treatment program.
Our team takes pride in providing patients with tangible tools and resources and playing a valuable role in increasing their level of comfort during their hospitalization. This position has given me increased confidence to have difficult conversations with others while maintaining empathy for their circumstances. While no one desires to be in the hospital, my hope is that we are able to bring a human touch to a challenging situation and leave patients feeling more equipped to make an informed decision about their tobacco use.
Ready for more evidence-based tobacco treatment knowledge? Don’t miss our upcoming comprehensive TTS Training, November 7-15, 2022. Click here to register!
About The Author Eiman is the Clinical Team Lead of the Inpatient Tobacco Treatment Program. She provides tobacco treatment counseling to patients during their hospitalization, supervises and trains medical providers and practicum students, and tracks quality metrics for program evaluation and improvement. Eiman received her Master of Social Work degree from the University of North Carolina at Chapel Hill in 2014. She is both a Licensed Clinical Social Worker and Licensed Clinical Addiction Specialist, previously working in community mental health addressing mental health and substance use needs in adults. She is passionate about empowering others to make positive changes in their lives. Eiman’s interests include co-occurring disorders, health and wellness education, and evidence-based practices for substance use treatment.