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Jennifer Folkenroth serves as National Senior Director of tobacco programs at the American Lung Association. Folkenroth leads tobacco programming efforts through a comprehensive, multi-pronged approach of education, awareness, behavior modification, community mobilization, systems change, advocacy and research. She is a certified Nicotine Dependence Specialist and holds a National Certificate in Tobacco Treatment Practice.
Interact for Health: Cigarette sales in the United States increased in 2020 for the first time in 20 years. How do we get back on track?
Folkenroth: More attention and progress must be made toward eliminating tobacco-related health inequities, including removing menthol cigarettes and flavored cigars from the marketplace and more states passing smoke-free workplace laws.
An unfortunate constant over the past 20 years is the unequal burden of tobacco use. The overall adult smoking rate has declined 35% from 2003 to 2019. However, this overall rate masks significant disparities among races and ethnicities and due to socio-economic factors. Smoking remains particularly high among Native Americans and Alaskan Natives and LGBTQ adults. Smoking among people with lower incomes and lower levels of education also remains high.
In 2022, the country needs to redouble its efforts to pass the proven policies called for in American Lung Association’s State of Tobacco Control. This will require an ongoing partnership at the federal, state and local levels to restart declines in adult and youth tobacco use and reduce the 480,000 lives lost to tobacco each year. Our elected officials must take stronger actions to put the country on a path to finally end tobacco use over the next 20 years.
Interact for Health: As the pandemic—and its associated stress and boredom—start to wane, are you seeing an uptick in calls to the Quitline?
Folkenroth: The American Lung Association’s HelpLine and Tobacco Quitline started seeing an increase in call volume for tobacco cessation over the summer of 2021 and that uptick has continued into 2022. Our marketing efforts were modified to reference messaging around tobacco users having an increased risk of severe illness from COVID-19, which was identified as a key motivator to quit. Continued, repetitive mass media messaging that counseling services are available to assist individuals wishing to end their tobacco dependency for good have directly attributed to the increase of Quitline referrals as well.
Interact for Health: As the pandemic subsides, what trends are you seeing in terms of vaping cessation?
Folkenroth: As many individuals are returning to work and re-engaging socially, the impact of COVID on tobacco use is becoming more evident. Recent trends show that employees are increasingly smoking and vaping on the job with 96% of tobacco users engaging while at work. This presents an opportunity for employers to shift their employee wellness programs back to focusing on improving overall quality of life and ensuring tobacco cessation programming and support is available for those employees wanting to quit. According to a recent benchmark study conducted by digital health company Pivot, 48% of employers plan to tackle tobacco cessation as one of their top three priorities for 2022. The American Lung Association is partnering with thousands of corporations nationwide to establish on-site tobacco cessation services by delivering evidence-based proven-effective programs, such as Freedom From Smoking. In particular employers are making Freedom From Smoking Plus available to their workforce as it is an online option that is self-paced, accessed anywhere from any digital device and provides one full year of continuous support to help an individual quit and maintain a healthier tobacco-free lifestyle.
The American Lung Association is also working to increase those programs available to schools, community-based organizations and parents to address vaping among adolescents. More than 2 million middle and high school students reported using e-cigarettes in 2021. We’re partnering with thousands of youth-focused agencies to implement programs to intervene and provide teens with voluntary cessation options.
For example, Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health, or INDEPTH, is an alternative for students who face suspension for violation of school tobacco, vaping or nicotine use policies. Students participate in a series of interactive educational sessions administered by an adult facilitator in either a one-on-one or group format in a school or community-based setting.
Not On Tobacco is a voluntary quit program for teens ages 14 to 19. Over the 10-week program, participants learn to identify their reasons for smoking, vaping or chewing; healthy alternatives to tobacco use and people who will support them in their efforts to quit. NOT For Me is a self-guided, online program … to help teens break nicotine dependency, no matter what tobacco products they use.
Interact for Health: You’ve spoken candidly about your own experience quitting smoking in your 20s. What helped you to quit?
Folkenroth: Thanks to routine screening, I discovered that I had early-stage cervical cancer. My OB-GYN advised me to quit smoking to improve the effectiveness of the cancer treatment and to decrease the risk of the cancer’s recurrence. Their message hit home that day and it was a pivotal moment that has positively impacted my overall health, well-being and freedom from tobacco dependency every day since. I encourage health care providers to advise the quit among all patients identified as tobacco users at each encounter. Your advice makes a difference.
Interact for Health: How has your own experience with smoking cessation impacted the way you approach your job?
Folkenroth: Quitting smoking is the toughest journey I’ve ever endured, and its one that continues 18 years later as I strive each day to maintain my tobacco-free lifestyle. My experience has helped me to understand the seriousness of tobacco dependency and empathize with the struggles individuals face along their journey to freedom.
Interact for Health: What is the most satisfying aspect of your job?
Folkenroth: Empowering others and being a part of their journey to leading happier, healthier lives is incredibly rewarding.
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