Luis García, center, and his smoking- cessation team at San Rafael Hospital in Alajuela.
Luis Diego Abadía smoked for 18 years. When his 3-year-old son asked him to quit, Abadía knew it was time.
Being an employee at San Rafael Hospital in Alajuela, northwest of San José, turned out to be an advantage for Abadía. Last October, the hospital opened its first smoking-cessation clinic. The clinic’s pilot group, which Abadía joined, was comprised entirely of hospital workers.
The initiative was started by health professionals, including doctors and therapists from different specialties. As the hospital worked at becoming completely smoke-free, helping hospital workers and patients quit smoking seemed only natural.
Led by occupational health specialist Luis García, the clinic’s coordinator, the program’s instructors were trained at Costa Rica’s Alcoholism and Drug Abuse Institute (IAFA), while a smaller group received training at San José’s Hospital Mexico. To test the new idea, program members encouraged hospital employees to join the clinic.
“For our first clinic we targeted a group of 24 employees who we thought might be willing to give up smoking. In the end, only eight joined the group, and only three made it through the entire period and were able to quit,” García said.
Although the first clinic’s results are disappointing, García said the experience was positive. He said success rates should increase with more experience.
On Feb. 2, the clinic will open its doors to the general public. In order to make it a community effort, organizers will first focus on helping Alajuela residents. The list of participants in the first public clinic is already filled.
To participate, applicants first must fill out a questionnaire and be evaluated by clinic staff. The questionnaire has 60 items that determine a smoker’s level of addiction, whether or not anxiety issues are present, physical condition and whether a smoker is addicted to other substances. Clinic staff members then determine who has the best chance of quitting.
“It’s not like we want to help just in the easy cases, but we try to concentrate our efforts on those candidates who we can actually help,” García said. “When [smokers] combine cigarettes with other addictions like alcohol or drugs, we can’t help them. We refer them to more specialized personnel so they can take care of those issues before they try to quit smoking.”
The clinic organizes nine sessions per group. Group meetings take place on Thursday afternoon. During the sessions, smokers are encouraged to choose a date to stop smoking. In each session, participants receive information about the dangers of smoking. They also are given tips on how to control anxieties and seek medical help if needed.
Sessions are led by different professionals, including cardiologists, pulmonologists, psychiatrists, occupational health specialists, epidemiologists, social workers, mental health specialists and breathing therapists. Each expert takes a turn during meetings and serves as a mediator to the group to help members encourage each other to quit.
“Our role is to support [smokers] through the process and provide medical or technical help if they need it. As a breathing therapist, I can also help patients with conditions that can worsen with smoking, such as asthma,” Michael Oviedo said.
Smokers experiencing difficulty reaching their goals may use pharmaceutical smoking-cessation products, such as nicotine candy or other products recommended by specialists.
According to García, the clinic is a work in progress, and organizers are hoping to improve success rates by increasing the number of tools at their disposal.
The hospital already has funds to buy a smoking analyzer, which tells smokers how much carbon monoxide they breathe out. As patients reduce the amount of carbon monoxide in each breath, they feel more encouraged to quit, García said.
With help from the hospital’s pathology department, smokers who participate in the next clinic will be able to see preserved samples of both healthy and sick lungs, and talk to patients suffering from lung cancer.
When Abadía completed the program, he hadn’t seen unhealthy lung samples or had access to a machine that analyzes breath. Nevertheless, Abadía hasn’t picked up a cigarette in two months.
“The clinic helps you find lots of external support from doctors, therapists and other smokers. You also receive the tools to convince yourself that it’s not worth it to keep smoking. But most importantly, they give you a structure in which you have to set yourself a date to stop smoking and keep it that way,” Abadía said.
Alajuela residents interested in joining the program can call 2436-1097 and ask for Yoheidy Herrera. Upcoming smoking-cessation programs are offered at the hospital from Feb. 2-March 29, May 3-June 28, Aug. 9-Oct. 4, and Oct. 18-Dec. 13.
