Tobacco use is the leading cause of preventable death in the state of Georgia, killing more than 11,700 people each year from smoking-related illnesses. Almost one out of every five Georgians uses a tobacco product, and the costs of associated health complications, such as cancer, heart disease, lung disease, diabetes, and pregnancy complications, to name a few, add up to $3.69 billion per year. 

The good news: quitting tobacco use has immediate benefits, and a steady stream of support is available for those ready to say, “Enough!” Studies show that working with a healthcare provider to access integrated tobacco cessation strategies, including medications and counseling, can increase your success rate by up to 300%. We chatted with AvitaCare Atlanta Medical Director Dr. Quintin Robinson about the top questions he receives regarding tobacco cessation treatment and how the medical facility’s team of providers leans into holistic, compassionate care to help patients turn over a new leaf for good.

AvitaCare Atlanta Blog: Let’s start with the big picture: What exactly does tobacco cessation mean, and why is quitting tobacco important for a person’s overall health? 

Dr. Quintin Robinson, Medical Director, AvitaCare Atlanta: Tobacco cessation simply means that a person stops using nicotine and tobacco products for good.  

It matters because smoking is the leading preventable cause of disease, disability, and death in the United States. We’ve all heard of heart disease, stroke, lung disease, and cancer. Tobacco use is linked to all of these conditions. Therefore, in theory, quitting tobacco would reduce your risk of being diagnosed with them.

The great news is that quitting smoking at any age lowers your risk of dying. The benefits are greatest for those who quit before age 40; they can avoid 90% of the excess risk of dying from smoking-related diseases. But those who quit later in life or after developing a smoking-related illness will still see health improvements, live longer, and ultimately feel better.

AvitaCare Atlanta Blog: You mentioned smoking. Many people associate tobacco use with smoking cigarettes. What other forms of tobacco use should people be aware of? 

Dr. Robinson: You’re right. People still tend to associate smoking with cigarettes. But there are many other types of tobacco products, including cigars, cigarillos, pipes, e-cigarettes, and hookah, as well as smokeless tobacco such as chewing tobacco, snuff, and nicotine pouches.

All of these tobacco products carry health risks. Some patients mistakenly assume that if they’re not smoking cigarettes, it’s safer. Take hookah, for example, which is very popular here in Atlanta. I hear from patients all the time, “That’s not really smoking,” and I have to correct them.

AvitaCare Atlanta Blog: The health risks of tobacco use are hardly a secret. So why is it so difficult for people to quit smoking or using tobacco? 

Dr. Robinson: There are a couple of factors that make it hard for people to quit. Nicotine, the natural stimulant in tobacco, is powerfully addictive because of how it affects the nervous system. When someone stops using tobacco, their body often reacts with withdrawal symptoms due to nicotine dependence, including irritability, anxiety, difficulty concentrating, restlessness, mood changes, sleep problems, and increased appetite. 

Another consideration is that smoking or using tobacco often becomes woven into people’s daily routines and behaviors. Maybe they have a cigarette when they get up in the morning or while driving to work. Or perhaps they smoke while socializing with friends. 

So you’ve got the double-edged sword of chemical dependence and learned behaviors. Quitting tobacco can take people out of their comfort zones, both physically and mentally, especially when they lack support to manage the process.

AvitaCare Atlanta Blog: Let’s discuss support for quitting. What evidence-based practices does the AvitaCare Atlanta team offer to patients? 

Dr. Robinson: There are many evidence-based options that aid in tobacco cessation. One of the most well-known is the nicotine patch. While patches are effective, we offer many other choices, including oral medications, gum, lozenges, an inhaler, and a nasal spray.  

One of the most effective options is behavioral support, or counseling. We don’t talk enough about how much a therapist can help you with the addiction component or with forming new habits when you’re trying to quit tobacco. 

Each of these measures, on its own, is more effective than quitting without assistance. But we’ve found that an integrated combination therapy, which may include a prescription medication, nicotine replacement therapy, and counseling, is the most effective way to help people quit.  

AvitaCare Atlanta Blog: Walk me through what it’s like to speak with an AvitaCare Atlanta provider about tobacco cessation. 

Dr. Robinson: There’s no one-size-fits-all tobacco cessation program. Each patient conversation is highly personalized. After we discuss what type of tobacco they’re using and how often, the first question we ask is whether the patient wants to quit and, if so, why. Because without internal motivation, the process is unlikely to succeed.  

Then we’ll review the available support for quitting. For nicotine replacement therapy, there are over-the-counter options such as nicotine gum, nicotine lozenges, and nicotine patches. Prescription medications that help people quit include two oral medications, a nicotine inhaler, and a nicotine nasal spray. We have an onsite pharmacy at AvitaCare Atlanta, so if patients choose a prescription medication, they can pick it up before they leave. 

We’ll also offer patients a referral to a member of our onsite behavioral health team for tobacco cessation counseling, or we’ll provide information about the Georgia Tobacco Quit Line, a free public health service that helps Georgians quit smoking, vaping, and using all forms of tobacco through phone, text, and online support.

AvitaCare Atlanta Blog: What do you say to people who have tried to quit before and were unsuccessful? 

Dr. Robinson: I tell them not to view their past attempts as failures but as practice runs. Ask yourself what you learned from them, then identify what worked and what didn’t.

A healthcare provider can help you identify the triggers that brought you back to tobacco and explore a combination of nicotine replacement therapy, prescription medication, and behavioral therapy.

Remember: Past attempts to quit are learning opportunities. Each time you try to quit, you learn something new about yourself.

AvitaCare Atlanta Blog: What about patients who feel unsure about where to start their journey to quit tobacco?

Dr. Robinson: I usually tell these individuals to first sit with the question of why they want to quit. As a medical professional, I can give a patient a list of health-related reasons to quit. But the real why has to come from them. 

One of the classic exercises we use is to ask people to pick a day by which they want to quit smoking and prepare for it. Even if you don’t completely quit by that day, you’ve set the intention.

It’s also important to remind people that they’re not alone in the process. AvitaCare Atlanta’s providers help patients identify the treatment and support that are right for them and encourage them to seek external support from friends and family or resources such as the Georgia Tobacco Quit Line. There’s never been a better time to quit! 

ABOUT DR. ROBINSON
Dr. Quintin Robinson is the medical director at AvitaCare Atlanta, an award-winning medical center, pharmacy, and laboratory that, in partnership with MedCura Health, provides compassionate, comprehensive, and inclusive primary and specialized care to the greater Atlanta community. He joined AvitaCare Atlanta in 2010. Prior to that, Dr. Robinson served as a consultant and staff physician in Infectious Diseases and HIV at HealthCare for the Homeless in Baltimore, Maryland. He received his Bachelor of Science in Biology from Xavier University in Louisiana, completed his Internal Medicine residency at Morehouse School of Medicine in Atlanta, and completed his Infectious Diseases fellowship with an emphasis on Domestic HIV at the University of Maryland in Baltimore. Dr. Robinson is Board Certified in Internal Medicine and Infectious Diseases, a Certified American Academy of HIV Medicine (AAHIV) HIV Specialist, and a member of the Infectious Diseases Society of America.