ORONO, Maine — Despite growing scientific evidence about the dangers of smoking and exposure to secondhand smoke, many doctors steer clear of discussing the issue with their patients, a tobacco cessation expert said Tuesday.
“It’s getting better, but many physicians don’t see this as part of their job,” said Fred Wolff, manager of education and training for the Center for Tobacco Independence at Maine Medical Center in Portland.
Wolff was among several presenters on Tuesday at a conference in Orono aimed at putting short, effective cessation techniques — “brief interventions” — into the hands of teachers, counselors, nurses and others with opportunities to support Mainers who are ready to quit smoking, or just thinking about it.
Topics included the importance of expressing empathy with smokers, acknowledging their ambivalence about quitting and inviting them to explore the positive and negative aspects of smoking versus quitting.
“Tobacco users often hold the belief that if they have tried to quit and failed, it is hopeless,” said presenter Dawn Littlefield of the Healthy Sebasticook Valley program in Skowhegan. In fact, she said, the opposite is true: Each time people swear off the smoking habit, the better they understand — and can avoid next time — the environmental “triggers” that cause them to start again.
“If they slip up, it’s just a slip-up,” Littlefield said. “We can help them get back on track, maintain their progress, and avoid the ‘all-or-nothing’ principle.”
Workshop participant Awa Conteh, a housing coordinator with the city of Bangor, said her clients, many of whom have a mental illness, often casually express a desire to quit smoking.
“I’ve never smoked in my life,” she said, “so even engaging them in a conversation is difficult.” Conteh said she expected to use some of the techniques presented at the workshop, such as helping clients express their motivations for quitting and the challenges they face in doing so.
Amy McCormick, a guidance counselor at Nokomis Regional High School in Newport, said the at-risk students she works with typically have more immediate problems to address, such as drug and alcohol abuse.
“It can be hard to prioritize smoking,” she said, but the brief interventions identified at the conference should prove helpful in keeping the issue on the table.
Wolff said the reasons doctors may fail to include therapeutic support for smoking cessation in their practices are complex. They include “a sense of hopelessness” about persuading addicted patients to kick the tobacco habit and the financial reality that insurance policies may not pay doctors for the time it takes to counsel patients through the sometimes drawn-out process of cessation, he said.
In addition to the statewide schedule of workshops, the Partnership for a Tobacco-Free Maine provides guidance and support to physician practices, dental offices and other clinical settings, Wolff said, including help in billing for tobacco cessation counseling.
About 40 people attended the half-day workshop at the Black Bear Inn from as far away as Farmington and Lubec.
The next workshop will take place on March 4 at the Penobscot Bay YMCA in Rockport.