JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —
The Brooke Army Medical Center Pulmonary Tobacco Cessation Team at Joint Base San Antonio-Fort Sam Houston is helping beneficiaries reduce and eliminate their dependence on a variety of tobacco products.
“We treat all types of nicotine dependence, not only the use of cigarettes, but other nicotine products to include cigars and electronic cigarette use,” said Dr. Jackie Hayes, BAMC pulmonary critical care physician at. “We also treat patients for use of smokeless tobacco products such as chewing tobacco, snuff and dips.”
The BAMC program has been in place since 2009 and patients can either be referred by one of their providers or they can self-refer into the program.
In addition to more traditional cessation programs, which focus on the behavioral health aspects of quitting tobacco products, BAMC’s program adds in clinical elements as well. The program integrates behavioral health with providers in the pulmonary and cardiology clinics to provide a more holistic approach to cessation.
“Our program is based on U.S. Department of Veterans Affairs and Department of Defense guidelines and other evidence-based best practices,” said Deborah Bray, BAMC tobacco treatment specialist. “We take the latest in treatment research and incorporate that into the program.”
Smoking is the leading cause of preventable death and disability in the nation. People forget that there is also a significant cardiovascular impact from smoking, said Dr. Michael Chatterton, BAMC clinical health psychologist.
With the rise of electronic cigarettes, or vaping, there is a new aspect to the dilemma. BAMC providers said their program includes a cessation program for those beneficiaries who want to quit vaping.
BAMC providers have said the problem with vaping is exacerbated when smokers, or other tobacco users, try to turn to electronic cigarettes under the mistaken impression that they are somehow “safer.”
“There is no research to support that it is any safer,” Hayes said. He and Chatterton said vaping can actually make the situation worse because many who try to use that as an alternative end up becoming dependent on both the electronic cigarettes and whatever form of tobacco they were already using.
In addition, tobacco products have a detrimental impact on performance, which is crucial to the careers of active duty military members.
Bray and other BAMC cessation team providers are focused on reducing, or removing, the dependence on tobacco products through a combination of behavior modification techniques and medications to combat the effects of the tobacco use on the patients.
The program starts with four weeks of two-hour counseling sessions. There is also medical management involved throughout the process. Following the sessions, there are follow-up phone calls that make up a total of a year of involvement by BAMC staff.
In similar programs nationwide, the average rate of success, meaning no relapse to tobacco usage, is 18 to 30 percent six months after the program ends. At BAMC, the average success rate is 38 percent for the same time period, with roughly 34 percent of participants staying tobacco-free one year after completing the BAMC program.
Wilford Hall Ambulatory Surgical Center at JBSA-Lackland has a similar program for personnel who are closer to that side of San Antonio and eligible beneficiaries can be referred to the program at either location. To self-refer into the BAMC program, call 210-916-2153.