Rose Aulino, a registered nurse who works in the Mental Health Center on the third floor of the Columbia County Human Services building, has helped dozens of clients beat their nicotine addiction. Every November during the American Cancer Society’s Great American Smokeout, Aulino, a.k.a. “Nicotine Ninja,” appears throughout the building, as if swiftly defeating a thousand discarded cigarettes. She wears a purple cape and headscarf, waving a larger-than-life cigarette replica, which she refers to as her “quit stick.”
Each year on the third Thursday of November, the American Cancer Society observes The Great American Smokeout to offer awareness and resources to tobacco users. Instead of focusing on quitting, they promote the message of beginning a tobacco-free journey. Their motto is, “You don’t have to stop smoking in one day. Start with day one.”
Although Nicotine Ninja appears just once a year, Aulino’s daily work is central to tobacco control and prevention work in New York State. As a health care provider who serves the New York State Smokers’ Quitline, Aulino partners closely with local experts at Tobacco-Free Action of Columbia and Greene and with a wider network of NYS Department of Health grantees from Advancing Tobacco-Free Communities and Health Systems for a Tobacco-Free New York. Grantees from both programs are part of the statewide effort to reduce tobacco-related deaths and disparities.
During our interview, Aulino shared a few of her clients’ nicotine journeys that have made an impact on her. To protect clients’ identities and medical privacy, all stories were kept anonymous during the interview. Quotations have been minimally edited for conciseness and readability.
QUIT STORY #2
In New York State, the average adult smoking rate is 12%, but tobacco use, including e-cigarettes, is highest among those who experience frequent mental distress (19.7%) and whose annual household income is less than $25,000 (20%). According to a 2021 survey from the New York State Department of Health, “17.4% of NYS adults living with disability smoked cigarettes compared to 10.1% of adults living without disability. Two out of every five adults who currently smoke in NYS are living with a disability.”
For folks with mental illness, Aulino says, smoking is an even greater part of a vicious cycle, because you’re stressed about money, and stress feeds smoking. For one woman in late adulthood addicted to nicotine, “money was a huge stressor,” states Aulino, “and even more so by the fact that cigarettes came first:”
We had to start really slowly because she smoked eight cigarettes just during her morning coffee … she really wanted to quit for health reasons … And she was very diligent about meeting with me every two weeks. When she would come in to see her psychiatrist, she would also come in to see me. So … before we even set a quit date, I wanted to get her back to one pack a day, because quitting from two packs a day … is a pretty daunting task for anybody.
“So what was the thing that did it for her?”
“The thing that did it for her,” Aulino states, “was … [meeting] her doctor … and I think that’s what finally convinced her to do it. But I think the money was also a factor for her. Because like I said, they were really strapped … we used NRT and … it took a while, but she was finally able to quit, and she saved a ton of money.” This supports the research that individuals have a much higher success rate of quitting tobacco if they have access to a healthcare provider. The New York State Tobacco Control Program has had many successes since its start in 2000, even though it received a mere 1.6% of the $2.36 billion revenue produced by Master Settlement Agreement payments and the tobacco excise tax in 2023. Led by the Department of Health’s Bureau of Tobacco Control, whose goal is to educate the public about the health and economic cost of tobacco use, the statewide program has helped reduce high-school cigarette smoking rates to an all-time low of 2.1% from 27.1% in 2000, and the adult smoking rate to 12% from 23.2% in 2000.
Despite these successes, there continue to be unmet needs. Although youth tobacco use continues to decline across all product types in the state of New York, one in five youth still use tobacco. E-cigarettes stand as the most used product among high-school students.
To be continued.