Tobacco Smoke Control in Memory Care

The chart relates important parts of effective tobacco smoke control in memory care presented at the Provision Living at Columbia, 13 February 2018, Resident Council meeting.

My trip to a smoke free city last week, San Antonio, Texas, made it very clear that common tobacco smoke control terms are confusing and misleading.

Source: First hand tobacco smoke is taken in by a smoker through the mouth. Second hand tobacco smoke is taken in through the nose. Smokers hold their cigarettes so as to avoid new second hand smoke. Third hand tobacco smoke exposure in memory care comes from the smoke that has settled in hair, clothes and bodies of smokers.

Restriction: Smoke free is an area that is free of smokers. It is not an area free of tobacco smoke. Tobacco free is an area free of smoking and free of tobacco smoke except for third hand tobacco smoke. Smoker free is free of tobacco smoke but can still be invaded by third hand tobacco smoke. These restrictions are not effective in memory care.

Smoker: The non-addicted smoker can honor a request to not smoke on the job and to even wait until after work to enjoy a smoke. Such a person does not carry a risk of tobacco smoke exposure to memory care residents. Addicted smokers must have an appropriate source of nicotine (lozenge) in a timely manner or burn tobacco to take in the needed nicotine in a toxic smoke.

Stage: Smokers who are quitting now find the smoke free environment in Provision Living a safe place to work. One still smokes when with relatives, however she no longer buys cigarettes.

Smokers can be classified by their readiness to quit and the amount they smoke by the Center for Disease Control (CDC) Missouri Quit Line, 1-800-784-8669, along with free counseling and a kit of alternative smokeless nicotine sources.

Alternative safe nicotine sources free of tobacco smoke not only provide help in breaking addiction but also provide an immediate elimination of third hand tobacco smoke in memory care. I found the lozenge is the most popular in local pharmacies.

Addicted caregivers could pick up needed lozenges for the shift when clocking in.

Three residents recited their experiences in quitting “cold turkey”. One left smoking behind when moving to Provision Living. One just quit; health and cost. Another was teased by friends to the point that he gave in. He then found out how much non-smokers “hated smokers”; for over 35 years that he had been smoking. 

A tobacco smoke cessation group was suggested. We now know that this must be done with the encouragement of the entire community to be successful.

The comment that membership would be kept private struck me as very odd. Success in breaking addiction demands a positive cooperative atmosphere. There must a celebration of purpose that overpowers the negative aspects of breaking free from addiction, or a significant emotional event like the three residents had before they moved into Provision Living.

The time has come that the “dirty secret” of exposing residents to third hand tobacco smoke in the residential health care community in Columbia needs to be made public to keep the air clean. Residential property is not a private place for people addicted to nicotine to share their toxic wastes.

The damage tobacco smoke does to the human body is no longer something that takes decades: lung cancer. The heart doctor we had an appointment with, prior to the resident counsel meeting, had the walls decorated with “Stop Smoking” and “Avoid Second Hand Tobacco Smoke.”

The threat to health is now known to be immediate. Blood platelets become sticky within 30 minutes of tobacco smoke exposure. Sticky platelets form clots. Clots cause heart attacks and strokes. Avoid second hand and third hand tobacco smoke.

My travels in the past four years still show Provision Living at Columbia to be the best for our money and for our care by radiant caregivers. Replace tobacco smoke with smokeless nicotine.