Allercy and Asthma Health
The Official Publication of AAN - MA

RTs Make a Difference in Asthma Care and Smoking Cessation

by Georgianna Sergakis, PhD, RRT, CTTS

“Tell me about your asthma: What makes it worse? What makes it better? How often do you use your albuterol inhaler?”

These are questions you might hear from a Registered Respiratory Therapist (RRT or RT) on your next visit to the hospital or doctor’s office. RTs serve as pulmonary health educators and ask similar questions of every patient with a respiratory condition. RTs use all the information we gather to recommend and adjust current medications and care plans according to evidence-based guidelines of the medical community. The use of respiratory care guidelines and standardized disease management help us teach you how to better self-manage your respiratory condition.

Imagine now that the chronic disorder an RT is treating is asthma along with smoking. Our additional questions would be, “Please tell me about your smoking: How many cigarettes do you smoke in a day? When do you typically have your first cigarette in the morning? Tell me on a scale from 1 to 10, how confident you are right now about quitting?” Likewise, we can use this information gathered to recommend and adjust medications and recommend further smoking cessation treatment for persons who have asthma and need to quit smoking to better manage their asthma.

There are national tobacco treatment guidelines that we use to streamline and systematically implement treatment for all people who use tobacco, including those who suffer from asthma. Today, more and more often, people who smoke can receive smoking cessation treatment in environments that include your local hospital, outpatient clinic, and even out in your community. As an asthma patient, have you received treatment of tobacco dependence during a hospital stay or a visit to a clinic? Has anyone followed up with you after you leave the hospital to see if you are ready to quit smoking or if you need assistance in quitting? If you have not, then you may want to seek assistance from your RT or health care provider (doctor, clinic, or community outreach) if you are ready to quit.

Tobacco use is the leading preventable cause of death. Tobacco-related diseases aggravate diseases like asthma. Other multiple diseases caused by tobacco use include cardiovascular disease, various cancers, and stroke.

Respiratory therapists are now working to expand our role as pulmonary health experts and take on this growing responsibility of counseling individuals on how to quit smoking. RTs have been successful in other areas such as asthma management, and now we know we can also make a huge difference in the lives of tobacco users. Due to tobacco-free policies in multiple environments (most notably health care institutions), tobacco users face extreme discomfort and withdrawal symptoms if not treated for their tobacco dependence while they are in the hospital. Facilities that implement these tobacco-free policies offer some support for patients needing help quitting during their hospital stay. But what about when you leave the hospital?

If you are a patient who uses tobacco, you should be offered counseling or treatment. You may encounter the five A’s — designed for those willing to quit — or the five R’s — designed to enhance motivation for those unwilling to quit:

  • Ask about tobacco use
  • Advise to quit
  • Assess willingness to quit
  • Assist in making a quit attempt through medication and counseling
  • Arrange a follow-up.

Or, if there’s resistance to quitting, these things would be covered:

  • Relevance — Receive motivational information relevant to your own personal reasons quitting would be important
  • Risks — Consider both the immediate and long-term risks of continued tobacco use
  • Rewards — Focus on the great rewards of quitting (saved money, improved status of your asthma, improved overall health)
  • Roadblocks — Learn to understand roadblocks to quitting and solutions to overcoming them
  • Repetition — Hearing these questions every time you meet can help you quit. Most smokers make several repeated attempts before they are successful.  Just because you tried once and were not successful, doesn’t mean you have to give up.

Respiratory therapists truly understand what tobacco users are going through, especially if you have asthma and you smoke. We treat asthma patients every day and pulmonary disease management is our specialty. When you’re ready (hopefully soon!) make a point to talk with your health care provider to find a quit-smoking program in your area — or ask them to refer you to a respiratory therapist or Respiratory Therapy Department offering these disease management services.

You can quit, and we can help.

Georgianna Sergakis, PhD, RRT, CTTS, is a member of the American Association for Respiratory Care. She is assistant professor of clinical allied medicine in the School of Health and Rehabilitation Sciences at the College of Medicine, The Ohio State University, in Columbus.

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