Dr. Sharwanda George, a clinical pharmacist at Joint Base Myer-Henderson Hall’s Rader Health Clinic, speaks about the clinic’s smoking cessation program on video. The video is available at https://www.facebook.com/jbmhh. Screen Shot courtesy Rader Health Clinic

Age increased to purchase tobacco, nicotine-related products

On Aug. 1, the undersecretary of defense directed that the age be changed to 21 to purchase tobacco and nicotine-related products in all military-connected retail establishments on military installations.

Dr. Sharwanda George, a clinical pharmacist at Joint Base Myer-Henderson Hall’s Rader Health Clinic, about a year ago studies were being done on the health risks of vaping and e-cigarettes.

“There were several cases last year but we haven’t heard a lot recently because of the pandemic,” said George. “About this time last year there were cases that were reported that quite a few young individuals were negatively impacted — their lungs were (harmed). The problem that you have when we start talking about nicotine-containing products, those products are actually marketed to the younger age group. The way they are marketed is they are cool. Those products can sometimes look like a USB port.

“The FDA hasn’t endorsed any of these things. You have the company’s manufacturing these products and they are putting this information out trying to tell you that (vaping or e-cigarettes) are what you (should) use if you want to quit tobacco — cigarettes or dip. It’s not a safe alternative. When you look at nicotine-containing products, they actually have as much as two times of nicotine in the vape and e-cigarette. You are getting about twice as much nicotine than you would have gotten from a cigarette or dip. It is definitely not an alternative to cigarettes and dip.”

George added that if parents are not aware of these products they will have no idea their kids are actually using nicotine-containing products because they look like new technological devices. Because of the marketing strategy directed at the younger age group, teenagers were being brought into emergency rooms with lung issues, explained George.

George said they are ensuring Soldiers are aware of the harmful effects of using nicotine-containing products. She said when they come into the clinic the initial visit includes two face-to-face visits that are now being done virtually due to the pandemic. The initial visit includes asking questions about how much and how long the Soldier has been using tobacco, has he or she attempted to quit in the past, if he or she is currently using alcohol or being treated for depression.

“I’m trying to get a background on (the Soldier),” she said, “that also helps me as far as trying to help the individual choose what particular quit aid might be best for them based on the information (he or she) gives me on the intake.”

George then explains to the Soldier how nicotine can affect various systems of the body. She said many people have no idea that the choices that they are making now affects them now and in later years.

“Some people have no idea that nicotine can affect your reproductive system,” George said. “If you have a young man smoking or using tobacco right now and in the next 10 years, (he) wants to get married and start a family, you might find you have a problem. Our young ladies who might decide to use birth control and you are using tobacco, it could result in you having clots and that’s another problem.

“I have information for them to explain how nicotine can technically affect you from the top of your hair all the way down to your feet meaning your poor circulation it just affects so many different systems.”

George pointed out the next step is giving the Soldier what she calls homework — exercises. The Soldier has to figure out what action or situation triggers him or her to use tobacco. After identifying triggers, George explains how using alternatives helps the individual with decreasing tobacco use. She then asks why the Soldier wants to quit tobacco.

“Usually it’s health reason or a lot of times it’s for their children,” she said. “As you quit, you’re still going to get the thought of wanting to use tobacco. When you get that thought of wanting to use tobacco, I want them to reflect back on why they quit in the first place so they don’t give in to tobacco.”

She added that nicotine replacement therapy, which includes nicotine patches, gum and tablets can be used as a quit aid. Possible side effects of quit aids are also discussed. One of the issues of quitting tobacco is possible weight gain. George said a nutritionist is available so the Soldier can talk about healthy eating habits.

Another aspect of helping is talking about the possibility of having a traumatic event happen such as a death in the family or loss of employment. George said these traumatic events could lead an individual to resume using tobacco products after quitting. She said the behavioral health coordinator is available to help an individual deal with these stressors or anxiety.

“Anxiety is usually the No. 1 trigger for someone using tobacco,” she said. “Whether it’s driven by marriage, income, a supervisor or organization they work for. The (behavioral health coordinator) can help with nonmedication ways of dealing with the stress and anxiety.”

Although many don’t view nicotine and tobacco use as an addiction, George said it is and combatting an addiction must start with the individual. She said the individual has to want to quit and no one can force he or she to quit.

“(I) try one person at a time … (I) try to encourage and say, ‘Hey you have to be the example to others.’ Some feel they can’t quit. I try to get each individual to buy in to cultural change.”

George also attempts to show Soldiers how quitting will benefit them financially. She said she has told Soldiers to put the money in a jar that they would use to buy tobacco or nicotine products. She said one person was able to buy a new car.

Although the services that are offered at Rader Health Clinic aren’t available to Department of the Army civilians, George said she can refer them to other agencies that offer the same services.

For more information or to book an appointment, call (855) 227-6331.

Pentagram Editor Catrina Francis can be reached at catrina.s.francis2.civ@mail.mil.