Ask the BJC Expert

Ask the BJC Expert

Smoking Cessation

Ellen Brennan

Published on Wednesday, July 26, 2017

Ellen Brennan is a lung nurse navigator seeing patients at Barnes-Jewish St. Peters and Progress West Hospital, in conjunction with Siteman Cancer Center.

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Today we are going to talk about stopping smoking and smoking cessation. I’ve got Ellen Brennan on the line with us and she is a lung nurse navigator. She treats patients at both Progress West Hospital and Barnes Jewish St. Peters Hospital. We are going to talk about ways that maybe you can kick the nasty habit. Ellen, good morning.

Good morning.

This is something that we all know. Smoking is bad for you. We have heard that since we were very, very young. Why do people continue to start smoking and why is it so hard to quit once they get started?

Well the thing is that most people start smoking when they are in their early teens and they don’t usually attempt to quit until early adulthood. By then it is usually addictive and it is very difficult to quit. I would say that the main reason that kids start smoking is, one, to experiment. You know it is viewed as an adventure to kids and it is something that is taboo and it is forbidden so they feel like they have to sneak it. Peer pressure obviously, we hear a lot about peer pressure. If they hang around other kids that smoke or if they have adults in their family that smoke, they feel like it makes them look more mature. It is very, very rare in all the years that I have worked with smoking cessation that people start smoking in their adult years. It usually is in the teen years that they start smoking.

What about the impetus to quit? It seems like it is very difficult for someone to stop smoking.      

There are two things. There is the addictive part of it and the habit part. The addictive part is the Nicotine. Nicotine is very, very addictive. It releases adrenaline which gives people energy but it also has a relaxing affect. I remember a doctor told me a long time ago, that it is actually the perfect drug if it wasn’t so bad for you because it does relax you but it also can give you energy. Then there is also that habit part where people associated with certain activities, driving a car, drinking a cup of coffee, after eating so they have the addictive part which is nicotine but it is also very, very habit forming.


What are some of the side effects that you can get from smoking?

The main side effect is that it causes blood vessels to thicken and grow narrower so you hear that people are at higher risk for heart attacks because their blood pressure goes up, their heart rate goes up and it also causes some to be at a very high risk for stroke. It damages airways which can lead to chronic obstructive lung disease and emphysema and a lot of times you see people with oxygen. Most of the time, that is from the effects of smoking and damaging the airways of their lungs and of course, one of the big side effect that you hear about a lot is lung cancer. Smoking is responsible for 90 percent of lung cancer deaths for current and former smokers. We know for sure that there are over 7,000 chemicals in cigarettes and many of those are poisonous and we know that at least 70 of those can cause cancer.

What about E-cigarettes? That is the hot thing right now. Are they any more harmful or less harmful than regular cigarettes?

You know that is a hot topic right now and it is very interesting because before I was asked to talk with you this morning, I would have thought the E-cigarettes would have been the perfect alternative to smoking but as I talked to physicians in the area and some of the pulmonologists, they said there has been a lot of research done and studies have shown that E-cigarettes definitely can cause emphysema. There are still a lot of studies out and it is unclear about E-cigarettes and their role in lung cancer but most physicians absolutely to not recommend E-cigarettes as a smoking cessation tool. I would be happy to gather more information and that is probably a whole other subject we can talk about.  

Yes, especially with the way we are just learning more and more about that. Obviously that is not the tool for someone. If someone really wants to quit smoking, what is the best way?

The best way is to join any kind of smoking cessation support group or class and I know that they are very intimidating and people get very nervous about signing up for a class thinking that they have to quit smoking. Really you should sign up for a class and then use any other tools. The more products or the more tools that are used those patients usually have a higher success rate such as smoking that you do in a class and adding a nicotine replacement patch or a medication. We will be having classes starting in October which will be free of charge and which we will be doing in a different way. It will be a four week class and they are absolutely free of charge so I will give you that phone number at the end as well.   

Sure. One other thing you mentioned is lung cancer which is directly associated with smoking. We see screening for early detection of other cancers. Is there anything for early detection of lung cancer?

We are very excited that in the past year or year in a half, Medicare now will pay for lung cancer screening through a very low dose amount of radiation CAT scan and as long as you are between the ages of 55 and 77 and smoked at least a pack a day for 30 years or even if you quit smoking. People don’t realize that even if they quit smoking they still are at high risk for lung cancer. If you quit smoking in the last 15 years, you are eligible for this screening. That is the other part of my job. I do help people quit smoking and I also do the lung cancer screening program.

A lot of information here Ellen. If people want to contact you and get more information, how would they do that?

My direct phone number is 636-916-7098 and I would be happy to give out more information about smoking cessation or the lung cancer screening program.  

Very good, once again, that is Ellen Brennan, lung nurse navigator. I love that title, lung nurse navigator at Barnes-Jewish St. Peters Hospital. Ellen thanks again for joining us. I appreciate it.

Thank you so much. 

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