HJNO Nov/Dec 2019

Healthcare Journal of new orleans I  NOV / DEC 2019 23 Disease Control & Prevention), currently 23.1 percent of Louisiana adults smoke. That is nearly a quarter of the state’s population. We estimate that approximately 460,000 Louisiana residents could qualify as Trust members. As of mid-September 2019, the Trust has approved nearly 104,000 Louisi- ana residents to receive free, covered ser- vices to help them stop smoking cigarettes. There are over 350,000 Louisiana residents who could conceivably qualify for free ces- sation benefits through the Trust if they would just take that first step on the journey to address their nicotine addiction. Who are some of the Trust’s partners, and what role do they play in reducing the num- ber of smokers in Louisiana? The Smoking Cessation Trust has been fortunate to enlist the close cooperation of the largest and most well-known health sys- tems in Louisiana in our quest to change the trajectory of smoking in our state. Our partners in cessation treatment have modified their electronic medical systems to better assist Trust members, opened new clinic locations or hospital departments, and increased outreach activities to more effec- tively reach their patients with the news of their relationship with the Trust, which makes the Trust’s free benefits available to patients who are approved for membership. Partners include, but are not limited to: Ochsner Health System Our Lady of the Lake Regional Medical Center East JeffersonGeneral Hospital St. FrancisMedical Center West JeffersonMedical Center Willis-KnightonHealth System Cardiovascular Institute of the South Imperial Health Thibodeaux Regional Medical Center The Rapides Foundation UniversityMedical Center NewOrleans Daughters of Charity Health Centers Each of our cessation partners have employed certified tobacco treatment spe- cialists, who receive special training and are certified to treat patients who smoke using methods that will increase the effectiveness of their attempts to quit. The treatment program is unique to each provider, and is designed to fit the way each program deliv- ers care to all their patients, not just smok- ers, so that patients can choose the type of care they want to receive. For example, if a patient likes a multi-specialty clinic setting, Ochsner or Imperial Health in Lake Charles might be a good choice, since both provider systems’care is delivered through a depart- ment within their clinic practice. If someone has cardiac issues, one of Cardiovascular Institute of the South’s 14 locations across south Louisiana might meet that need. If someone is more comfortable in an outpatient hospital setting, Willis-Knighton Health System in Shreveport, East Jefferson General Hospital orWest Jefferson General Hospital in the Greater New Orleans area, or St. Francis Medical Center inAlexandria, Louisiana might be the best choices. For those living in rural areas, where find- ing a local provider who is trained in ces- sation care is difficult, our members can access Redbrick Health, our Quitline pro- vider, who can assist callers by telephone to help locate partners who provide telemed- icine, which is face-to-face care via tele- phone, personal computer, or smartphone. Further, some independent physicians across Louisiana are approved to treat Trust patients once they have been approved by our network partner, Gilsbar 360 Alliance PPO Network. Providers can obtain infor- mation to join Gilsbar 360 Alliance PPO Network by calling 1-866-605-6797, and a Gilsbar representative will be happy to assist with the process. We are seeing a resurgence in nicotine addiction with the recent emergence of e-cigarettes and vaping. How do we get existing smokers to quit, and young people to never start? Our mission is to help assure that the “Scott Class” (Louisiana residents who started smoking cigarettes before 09/01/1988) have services available that can help them quit smoking cigarettes. However, there are efforts in the legislature, parishes, cities, and towns across Louisiana to ban these dangerous substances, or make them harder to purchase through cigarette taxes and increasing the legal age to pur- chase them. There is good evidence sup- porting the notion that these actions, if they are put into place, may decrease the overall smoking prevalence in Louisiana. I can cite two examples; first, the U.S. Institute of Medicine estimates that moving from 18 to 21 years of age for the legal age to smoke will decrease the smoking preva- lence by 12 percent over time. Second, rais- ing tobacco taxes is known to decrease the smoking prevalence by 2 percent for adult smokers, and 3.5 percent for youth smok- ers for every 10 percent increase in the retail cost of a pack of cigarettes. Louisiana’s cur- rent tobacco tax of $1.08 per pack ranks Louisiana as 36th among the U.S. states and the District of Columbia. The District of Columbia, at $4.50 per pack, is the highest among the 51 jurisdictions in the U.S., while the State of New York was a close second at $4.35 per pack. Missouri has the lowest tobacco tax of all states at $0.17 per pack. If Louisiana were to increase its tobacco tax from $1.08 to the average for the 50 states ($1.73/pack), the results would be between a 12 percent and a 21 percent decrease in the smoking prevalence. A 12 percent drop in the adult prevalence from 23.1 percent to 20.3 percent would improve the quality of life for about 126,000 Louisiana residents that today suffer the ill-effects of smoking. As for vaping/e-cigarettes, the Smoking Cessation Trust’s court order dictates that Trust benefits are available only to Loui- siana residents who started smoking cig- arettes before 09/01/1988. However, if an approved Trust member needs help, the specific cessation benefits provided by the Trust are recommended as a remedy for nicotine addiction, no matter which deliv- ery method was used. Therefore, if a Trust member (by definition, a nicotine-addicted individual) is vaping and smoking, then they can receive treatment to help them quit smoking that should work equally well to relieve them of the need to vape. Addi- tionally, the Louisiana state quit-line (Quit with Us: 800-784-8669) is available to all