January 24, 2020
Although Kyle, 22, had tried half-heartedly in the past to quit vaping, it wasn’t until he graduated from college in May 2019 that he decided to get serious about quitting. His four years of vaping and three years of using chewing tobacco had started to take its toll on him.
“It started affecting my health. It was hard to breathe, and I’d spit up mucus. So I was definitely more motivated and I told myself after school was finished that I was going to quit vaping,” he says.
Around this same time, Kyle met with pediatric neurologist Felicia Gliksman, D.O., at Hackensack University Medical Center about lingering symptoms from an earlier concussion. It was during this appointment that he learned about the New Jersey Quit Center, Hackensack’s smoking cessation program.
“As part of our history-taking, we ask about tobacco use, and Kyle mentioned vaping,” says Dr. Gliksman. “We actually ended up talking a lot about that and less about the concussion. We had a very positive discussion.” Dr. Gliksman could see he was motivated to quit and referred him to the New Jersey Quit Center.
There, he met with Nathalia Allen MS, TTS, a tobacco treatment specialist. At the time of his first assessment, Kyle had already started to use nicotine gum and reduce his tobacco use. “He’d started motivating and building himself up,” says Nathalia. Prior to this, he used the JUUL, a brand of electronic cigarette that looks like a USB drive and that has more nicotine than most other e-cigarettes. Kyle had been smoking about one-and-a-half JUUL pods a day—the nicotine equivalent to one-and-a-half packs of traditional cigarettes.
A Combination Approach to Quit Vaping
The New Jersey Quit Center offers three components as part of its treatment: nicotine replacement, behavioral modification counseling and a text messaging support system.
“Studies have shown that behavioral interventions combined with nicotine replacement therapy have higher success rates versus trying without support or without nicotine replacement,” says Nathalia.
For nicotine replacement, Nathalia recommended a combination therapy of nicotine gum and patches for Kyle. He started with 21 mg transdermal nicotine patches, reducing to 14 mg and then 7 mg. Kyle also used 4mg gum during strong trigger situations.
“After being on the 14 mg for about a week, I started forgetting that I needed it. Once I got down to 7 mg, I was really off it. I was probably chewing the gum for about week or two after that, but not every day,” says Kyle. “I’d say the combination of the two definitely worked.”
Nathalia and Kyle worked together to identify his triggers and develop strategies to modify his behavior. Because he recognized that being around friends who used the JUUL was a trigger for him, he decided to limit contact with them temporarily. Happily, his friends are no longer a trigger for him. “I’m completely past that and I don’t really have cravings at all anymore. So when I see them, they see how I’ve succeeded and I’m inspiring my friends to quit vaping instead,” he says.
Kyle also decided to adopt strategies such as hiking, eating healthier and going to the gym. “He mentioned that he was interested in hiking and that it could keep his mind off smoking. And another strategy that we developed was going to the gym because, for him, it was a stress relief,” says Nathalia.
The third component of his treatment was a text messaging service designed to help patients as they quit smoking. Along with automatically receiving motivational messages, patients can use it to text their tobacco treatment specialist to receive one-on-one support between appointments.
“The text messaging definitely helped. I’d get different tips and tricks to try,” says Kyle. “Nathalia would recommend things to try if I had a craving or ways to keep myself calm.”
A Healthy Future
After three months on the program, Kyle had weaned off the patch and the gum, and wasn’t using any type of nicotine. He’s now breathing and sleeping better, and continuing to enjoy the lifestyle changes he made, such as eating healthily and hiking, as part of his recovery. By ending his dependence on nicotine, he’s made a step toward a longer and healthier life.
Dr. Gliksman is grateful she had the chance discuss vaping with Kyle. “Being in the world of pediatric concussions, I don’t have the opportunity to talk about smoking cessation or alcohol cessation often. Just knowing it was something that he was interested in doing, and that he actually pursued it and succeeded, is very, very rewarding,” she says.
Kyle is enjoying his new lifestyle. “I feel a lot healthier and I’m all around happier,” he says. “I feel stronger minded and I’m proud of myself for being able to quit.”
Felicia J. Gliksman, D.O., is board-certified in neurology and psychiatry with special qualifications in child neurology, and practices in Hackensack. To make an appointment, call 551-996-3200.
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