Stay Quit, Get Fit

Stay Quit, Get Fit Henry Jackson noticed his neighbor wasn’t joining him for their usual smoke breaks on the front stoop. When he asked his buddy why, he learned about the quit smoking classes at the health center nearby, the 11th Street Family Health Services of Drexel University. “It’s not like thinking of quitting was a new idea or anything, you know, I just hadn’t thought about doing it right now. But who am I going to smoke with now? You know, that’s part of what’s nice about it, we get a little break from the house, the wife, the work and it’s just men time on the stoop.”

At forty-two years old, Henry works long hours, he uses public transit or his feet to get everywhere, and even though he’s been told he needs to get his blood pressure under control, it just hasn’t been a priority. “I’ve got a family to feed and take care of, you know.” He had no idea just how much the classes were going to impact his life. At the first class, the nurse took his blood pressure and checked his lung volume with a spirometer. She told him his blood pressure was dangerously high and that he had the lungs of a much older person. “She put it to me real and said if I really did want to take care of my family, that I had to get serious about taking my medications and get REAL serious about quitting smoking.” The counselor who provides the classes explained how smoking made his health problems worse. “And she told me about how my body tries to heal itself when I stop quitting. Man, that gave me some hope, you know?”

Henry was active with his class, enjoyed the support he received from his peers and the staff at the health center. He loved the free membership to the health center’s fitness center, and stayed committed to the group’s exercise and cessation meetings twice a week. By the end of the program, his blood pressure was under control and he felt so much better overall. “And my smoking buddy, now we lift weights and workout together. You know, we’ve still got to get out of the house.”

The smoking rate for the residents in this Philadelphia neighborhood is 32.7%, 10% higher than the national average for African-Americans. Over 50% of the uninsured residents in this area are smokers. City-wide, poor residents are 67.3% more likely to have tried to quit than non-poor residents (55.9%). Programs like ‘Stay Quit, Get Fit’ that take a culturally appropriate, comprehensive approach to tobacco cessation are essential to reducing (or even eliminating) health disparities in this community.

Individuals like Henry face many challenges when trying to quit smoking. Smokers build their lifestyle around smoking; hence quitting is a threat to their daily routines and social networks. The ‘Stay Quit, Get Fit’ program, funded through the American Legacy Foundation, brings a multi-faceted approach to low income African Americans trying to reduce or quit smoking. Three elements combine to make the program effective and unique. Each course of classes works to:

• Build new relationships around positive behaviors and peer support,
• Directly demonstrate how health status improves when tobacco use is reduced, and
• Provide participants with tangible signs of progress and reinforcement over time.

‘Stay Quit, Get Fit’ incorporates group cessation counseling with group exercise. Participants build relationships with others trying to quit and develop exercise ‘buddies.’ The program resides at a nurse-managed health center where participants’ health measures are taken repeatedly, providing feedback on the impact of tobacco on participant health, including lung volume, blood pressure, BMI and fitness level. As patients at the primary care center, program participation and health measurements become part of the participants’ electronic health record. Nurse practitioners and other providers at the center reinforce cessation messages every time they are seen. The providers help these patients manage their chronic diseases made worse by tobacco use. When participants see their health improve through reduced tobacco use, their choice to quit or cut back is reinforced. They also realize the connection with managing their chronic condition whether it is high blood pressure, diabetes, asthma or others.