The Crucial Role RTs Play in Ending the Smoking Epidemic

On this episode of the AARC Perspectives Podcast, we talk with Natasha Toropova from Global Action to End Smoking to showcase the pivotal role respiratory therapists can play in smoking cessation, especially as they see patients at crucial moments and provide personalized support. Toropova also details how integrating global resources and evidence-based interventions into everyday practice can revolutionize patient outcomes and profoundly reduce preventable deaths.

Additional Resources:
Global Action to End Smoking

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Transcript

Lisa Weisenberger 0:11

Thanks for joining us today for AARC Perspectives Podcast. I'm Lisa Weisenberger, AARC Director of Content and Communications, and I'm here today with Natasha Torupova from Global Action to End Smoking. Today we're going to talk about Global Action to End Smoking's mission, how their organization is impacting smoking cessation rates for respiratory patients around the globe. Hi, Natasha. Can you tell us a little bit about Global Action to End Smoking and what your organization's mission is?

Natasha Toropova 0:37

Hi, Lisa. It's a great pleasure to be here today. Thanks so much for the invitation. At Global Action to End Smoking, our mission is very simple, but yet quite ambitious. We are trying to make smoking obsolete in this lifetime. So we are a health-focused organization working at the intersection of policy, research, and innovation. This means we don't just say that smoking is bad, everyone knows this anyway, but we are actively investing in tools, strategies, resource, resources that actually help people who smoke move away from combustible tobacco. So what makes our approach different is that we recognize a hard truth. Nicotine is super addictive, it rewires our brains, it's a physical, social, social, emotional dependence, and people are not going to quit overnight. So that tells us that just focusing on prevention or willpower is not enough. Instead of focusing only on that, we are trying to support evidence-based solutions that reduce harm, accelerates cessation, and we are trying to meet people who smoke where they are, demonstrating no judgment, but on the contrary, treating them with compassion and kindness. So ultimately, the success for our organization looks like a world where lighting a cigarette would feel as outdated as lighting a cigarette now on an airplane.

Lisa Weisenberger 2:25

That's a great analogy.

Natasha Toropova 2:29

I mean, 20-23 years ago, people smoked on the airplane, right? And everyone else tolerated that. So now it seems that that just couldn't have been true. But was our reality. So let's hope that smoking will disappear just like smoking on airplanes.

Lisa Weisenberger 2:50

Fingers crossed, right? Along those same lines, you know, people know that smoking is often described as the leading preventable cause of death. What does the scale of the problem look like in the United States and globally? You talked a little bit about hoping to eradicate smoking, but tell us a little bit about that.

Natasha Toropova 3:08

So, yes, thank you. The scale is staggering and often underestimated. Indeed, smoking is the largest single preventable cause of death. As we know, smoking kills half of people who smoke. Just think about this. Do you think that if a person who is a smoker knew that there is a 50% chance that they will drop dead after their next cigarette, would they still continue smoking? That's something we don't know the answer to, right? To me, smoking often feels like this Cassandra's curse. She was a character in Greek mythology, and she could foresee the future. But she also was cursed that nobody believed her. She was trying to prevent all kinds of tragedies, misfortunes, grief, but no one believed her. So that all happened. And often when we are talking about the problem of smoke and combustible cigarettes, that's how I feel. It's a Cassandra's curse. Here are the all facts, right? Facts are stubborn things. Here are all tools, how to change it, how to change smoke in an epidemic, but yet nothing is happening. So in spite of the decades of great progress, smoking remains the largest cause of death. And that's a completely unacceptable. Global tobacco today kills more than 7 million people every year. And think about this: this is not just statistics, that's like entire cities disappearing annually. So if you think of this from this perspective, that's pretty scary. And um, there are still about 1.3 billion tobacco users worldwide. Most of them do live in low-middle-income countries. However, in the United States, tobacco causes around 360,000 deaths every year, accounting for one in five deaths. So when we are, you know, people are usually not impressed by numbers, as we know, because numbers do not sound like their stories. So let me just say that behind every number is someone's story, is someone's tragedy, right? That means that someone didn't live enough, long enough to see their kids grow up. Someone didn't make it to see their grandkids. Like my mom was a chain smoker all her life. She passed away when my son was only six months old, and that was a tragedy for our family. If she never smoked, I know she would have still been with us. So things like that. That's why smoking isn't just a public health issue. It's a daily believed reality, you know, at homes, in clinics, in um, you're right.

Lisa Weisenberger 6:09

My mother passed away when I was young as well due to smoking. I know exactly what you're talking about. A lot of times patients are told, you know, just quit. It's easy, it's no problem. Like you should be able just to stop doing it. Why does that approach fail so many people?

Natasha Toropova 6:25

You know, this is a very uh hypocritic question, right? When people say, you know, why don't you just quit? Well, if a person is dealing with asthma, for instance, right, would people consider still saying, hey, why would you why wouldn't you just stop coughing or you know, sneezing? sounds awful, right? Sounds very cynical. And yet this is the same thing, only worse. Addiction, addiction does not depend on slogans, right? Addiction does not get changed by slogans. We also realize that if a person who smokes is addicted, obviously, addiction also controls the life of their family in a certain way, right? But the whole family is a hostage of their smoking as an addiction. Nicotine is one of the most addictive substances because it rewires the brain's reward system, ties itself itself to stress, identity, to daily routine. So when we tell someone, hey, why don't you just quit? We're actually asking this person to break a chemical dependency. How many people do we know who've done that on their own? We're asking a person to change the ingrained behaviors and often do it during the time of illness or stress or other challenges a person is going through all at once. This is not happening. And again, you know, many people think that if a person is not able to quit smoking, this person is weak. It's the fault of this person, and that's completely wrong, wrong, wrong. And this is what we at Global Action just refuse to accept. Every person who is smoking and is trying to quit, and according to the data, at least half of smokers are trying to quit and have tried quitting at least once during the year. Most of them unsuccessfully. So when we hear stories like that, we say this is wrong. Treat a person with compassion. Listen and take a look at their journey, at their personal journey, probably full of hardships and sufferings and challenges, right? Treat them with compassion. So that's why most smokers never quit on their first try. And that's not a failure of motivation. According to statistics, only 4% of people who smoke can quit cold turkey. And then even there is a percentage out of this 4% that goes back. So it's not long-lasting. We have to treat smoking as any other chronic condition. Then to start with, and if we did this, then you know, not many people would be asking such questions as why don't you just quit quit, are you weak, that frequently. So if we treat it, if we treat it as a chronic condition, again, like asthma or diabetes, right, their response, their response, their reaction would be completely different. That's why if you know someone in your family, in your environment who smokes for many years, who is a chain smoker, a confirmed smoker, they call people like that. Ask this person, talk to this person, have you ever tried quitting? If yes, what went wrong? Have you tried anyone's help? And again, you know, you need the support network and you need all kinds of tools which are now, thank God, available for a person smoking, trying and willing to quit.

Lisa Weisenberger 10:13

So, how do how can respiratory therapists access these resources?

Natasha Toropova 10:17

Yeah, so Global Action to End Smoking has a great database, and we'd be very happy to share our database and research with respiratory therapists because we see great partners in them. The position of respiratory therapists is very powerful because they are they are at an incredible intersection. They can prevent, they can intervene, and as I said, they can redirect a person at a certain point of their life, right? So when it comes to smoking, this intersection becomes even more important. They are there afterward, helping a patient to recover, to stabilize. So that means that RTs have multiple opportunities, not just once, but over time to help someone move away from smoking. You know, our website is full of incredible resources, and then also our team will be happy to talk, to communicate, and provide an individual approach depending on a specific request. We also would be delighted to share our experience, but also to hear and to listen to the experience that RTs can share with us.

Lisa Weisenberger 11:42

Yeah, we'll be sure at the end of this podcast and on the page where this podcast will live on aarc.org to share the link to the Global Action to End Smoking's website. So if we continue to succeed in significantly reducing smoking over the next 10 to 20 years, what do you think that would mean for patients and for the respiratory care profession?

Natasha Toropova 12:05

Again, as I said, for RTs, that would be transformative. It also would be transformative for people who smoke, right? But for uh respiratory therapists, they are at the center of this? Other than smoking, it's the largest, single largest preventable cause of death, it's also the major driver of all respiratory conditions today. You name it lung cancer, bronchitis, emphysema, it's all about smoking. So every time an RT talks to a person who smokes, this is the condition. So we should prevent it, we should treat it, but always address the fact that this is an addiction. You know, it's not just free will that a person decided to take. It's an addiction, and it's in the capacity and power of a respiratory therapist to help a person at least think about this. Respiratory therapists, meet patients at the moments when breathing is no longer something they take for granted, unfortunately. As I said, ideally, there is always a moment when it's not too late, when it's just the beginning of the journey. And as I mentioned, it's important that an RT advises to change the trajectory of someone's life. And just think how wonderful it would be, right? We all dream of different trajectories for our lives often and for the lives of those who left us, for our parents, friends. I also think when when someone is hospitalized, for instance, for a COPD exacerbation, right? Or someone who is starting oxygen for the first time, the conversation about smoking stops being abstract. It's becoming all of a sudden very personal, very bitter and real. And I think that's also something to always keep in mind that RTs have something uniquely valuable, that is the credibility and continuity. So they're not just delivering the message to a patient, but they're actually helping a patient breathe. So if you think about this from this point of view, I mean that's pretty overwhelming and powerful. And I think that the more RTs focus on that, the more they realize their power, superpower in a way. I know it doesn't seem real, but I'll be honest, 10 years ago it didn't seem real to me that all those changes in tobacco control legislations could be in place either. And and I know the battle was very hard because the tobacco industry was on the other side of that battle. Now it's the people. People who smoke, people who need our help. They are now in the center of attention. So if if we reduce smoking, this would be transformative both for people who smoke, for their finalists, and for professionals. That would mean that fewer people would gasp for air in emergency rooms, right? Fewer late-stage lung cancer diagnosis. This more years of healthy, active life. Who doesn't dream of that? And the best part is that this is achievable. And this can be happening like now, because we now have it all. As I said, it's not only about the knowledge, about the tools. The tools are here. The knowledge is here too. It's just about the implementation and continuing to share the experience, the news, and because this is power. So for respiratory therapists, it would, I think, totally shift the nature of their work. To see their patients, or at least most of their patients, thrive. Instead of constantly managing preventable crisis, there would be more, I think, focused on recovery, on rehabilitation, and long-term health. So this could be a good transformation. It certainly doesn't mean that respiratory therapists would be less essential. No, that's not the case. It means that their impact would evolve from crisis response to sustained health improvement. So I I find it fascinating. And in many ways, it would be a sign of success. I mean, it would be success, let's just put it this way.

Lisa Weisenberger 17:05

I think that's probably a really good way to wrap it up about the hope for the future within all of this. So, do you have any final thoughts to share?

Natasha Toropova 17:13

You have to remember, what people have to remember, that it doesn't need to be a major breakthrough, an immediate breakthrough. In ending smoking, interventions which are to happen every single day. So I think that if we take this problem from this point of view, then it's very inspiring. So, and again, just remember that respiratory therapist would be at the center of this.

Lisa Weisenberger 17:51

Thank you for joining me today on this episode of the AARC Perspectives Podcast and for sharing the Global Action to End Smoking's mission and the important work, critical work that you're doing to support better breathing and smoking cessation. Be sure to subscribe to AARC Perspectives wherever you download or listen to your podcasts.