Costs don’t seem a substantial deterrent. With our $2.75-per-pack pack excise tax on each pack — the highest in the nation — a pack-a-day smoker spends $309 a month to feed the habit, a big chunk out of the monthly budget. \A more moderate smoker, as many are now as there are fewer and fewer places to light up, one who smokes, say, five cigarettes per day, will still pay $76.87 per month at current pack prices. But these sums are just a drop in the bucket compared to the cost of health care to treat the diseases caused by tobacco, about $50 billion a year nationwide.
Though clearly the problem needs to be addressed at the national and state levels, individual local care providers are depended upon to identify smokers and intervene to provide resources and help for quitting. This is a priority for IFH and HRHC.
According to Theresa Miller of the Tri-County Cessation Center in Lake Katrine (one of 18 in the state), whose state-funded program covers Ulster, Dutchess, and Sullivan counties, a tobacco user identification and intervention system interfaces with doctors’ and dentists’ offices, hospitals and addiction treatment centers. IFH and HRHC ask about tobacco use at every relevant clinical visit.
“If a patient is identified as a smoker, the clinician then advises the patient to quit and assesses their willingness to make a quit attempt,” said Miller. “If the patient is willing to make a quit attempt, the clinician shares quit tips, discusses the possibility of prescribing stop-smoking medications, offers additional quit materials, and with the patient’s consent will refer them to the NYS Smokers’ Quitline, who will then call the patient at home.”
Virna Little, senior vice president for psychosocial services, said all primary-care providers are taught to ask patients about their smoking habits. “[We’ve] programmed our electronic health record so providers have accessible information and resources for patients who want to quit,” Little said. “We also provide counseling to patients who want additional support.”