THE SMOKING PROBLEM: A stubbed out cigarette inside the American Legion post in Fairmount. According to Marion General Hospital, 31 percent of Grant County adults smoke cigarettes. This is nearly double the national smoking rate of 17.5 percent. Staff photo by Clay Winowiecki
THE SMOKING PROBLEM: A stubbed out cigarette inside the American Legion post in Fairmount. According to Marion General Hospital, 31 percent of Grant County adults smoke cigarettes. This is nearly double the national smoking rate of 17.5 percent. Staff photo by Clay Winowiecki
Thirty-one percent of Grant County residents smoke, which is tied for second worst out of Indiana’s 92 counties, according to Kelley Hochstetler, community education coordinator at Marion General Hospital.

But digging down into why we have such a high smoking rate isn’t as cut and dry as the numbers are.

According to Hochstetler, some contributors include a high poverty rate, mental health issues and substance abuse.

Another possible factor is the “James Dean Effect,” a term coined by Jennifer Lane-Riefler, executive director of Cancer Services of Grant County.

“We elevate James Dean here,” Hochstetler explains. “As a coalition we’re trying to be on the lookout for how we can elevate James Dean without a cigarette under his t-shirt sleeve or without him visually smoking.”

Historically, Marion is a manufacturing town as well.

“That has shifted an awful lot, but somehow we still have that mentality,” Hochstetler said.

When digging into Grant County’s tobacco use numbers, perhaps no statistic is scarier than this one: 31.4 percent of pregnant women in Grant County smoke. This is more than double the state average of 13.5 percent.

When expecting women smoke it can cause low birth weight, which Grant County has a high rate of, contributes to sudden infant death syndrome and reduces newborns lung functions, Hochstetler said.

To combat this, Marion General Hospital launched the “Baby & Me Tobacco Free” program.

“We’re trying to work on where this (smoking) mentality is coming from,” she said. “We can make comments on (why we believe people smoke), but we really need to dig down to find out why it’s such a problem (in Grant County.)”

Pricing out would-be smokers

For Glen Spears, a forty-five year smoker, cigarettes are a relaxing addiction.

“It’s the worst habit I’ve ever had in my life,” Spears said.

Spears began smoking at the age of 15 when a friend handed him a cigarette. Since then he’s tried to quit six times.

“I’ve driven down the road and thrown a pack of cigarettes out the window and the next place I go ... I am looking for another pack of cigarettes,” he said. “I’ve been addicted to drugs in my life and I’ve put them down. This I cannot quit.”

According to Hochstetler, the county’s smoking numbers haven’t improved recently. So when it’s common knowledge that smoking is bad, why don’t smokers stub out their bad habit?

“From what I hear it is very difficult to quit,” Hochstetler said. “I don’t ever want to be judgmental of how hard it is to quit.”

Marion General Hospital does want people to reduce their use and stop smoking, but its priority is to stop people from beginning in the first place.

The best way to stop people from starting is to raise the cigarette tax, Hochstetler said.

“The number one reason people will not start is if the cost goes up,” she added. “If I’m a smoker I can see why I wouldn’t want (the price) to go up because it’s more cost out of my pocket, but if we try to look at it in the bigger picture ... most people who smoke realize it’s not the best of habits.”

While we all have habits that maybe aren’t the healthiest, smoking is a habit that everyone surrounding the smoker has to live with, she added.

In Grant County, that’s deadly. Fourteen people died due to secondhand smoke last year, according to MGH.

Secondhand smoke, caused by being near someone who is actively smoking, offers passerbys the same levels of tar that actually smoking does.

“That number should concern us,” she said. “What if we had an accident where that many people were killed? That would be horrific. This is horrific too.”

From a financial perspective, the economic burden of secondhand smoke in Grant County is $23.4 million.

Now even thirdhand smoke has become a real concern among medical professionals.

One example of thirdhand smoke is when someone has a cigarette outside their home, puts out the cigarette, then walks back inside. Now, everyone inside is vulnerable to thirdhand smoke.

Changing the public perception

According to Rocky Whitehead, director of advocacy at Cancer Services, smoking is the number one risk factor for cancer.

Smoking not only increases the risk of lung cancer, but also bladder, throat, kidney, liver, stomach, pancreas, colon and cervix cancers, Whitehead said.

“It affects your blood pressure (and) it increases your risk of stroke, coronary heart disease, COPD and emphysema,” Whitehead added. “If you already have asthma and smoke, you’re more likely to trigger an asthma attack or make it worse than normal.”

According to Miranda Spitznagle, director of the Indiana Tobacco Prevention and Cessation Commission at the Indiana State Department of Health, reducing tobacco consumption needs to start at the local policy level.

“That’s a key factor for the community to take a look,” Spitznagle said. “Where smoking and e-cigarettes are allowed in the community.”

Spitznagle always encourages worksites and public places to commit to maintaining a smoke-free interior and exterior.

According to Spitznagle, by removing smoking in public places the public perception of smoking can change.

“We want to make sure young people don’t see the use of tobacco in their community,” she added.

In Grant County, a smoking ban ordinance will be voted on at the Grant County Health Board meeting Monday at 5 p.m.

The proposed ban would prohibit smoking in bars and public places.

If the ban passes the health board, it will be sent to the Grant County Commissioners for a final vote.

However, the proposed ban has drummed up opposition among local businesses who fear it would seriously impact their bottom line and as well as those who fear they would lose their rights.

According to Spears, even though smoking is addictive, he is against a smoking ban in Grant County.

“(Smoking bans have) driven a lot of our military organizations basically out of business because (customers) can’t come in, sit down, relax, have a drink and have a cigarette,” he said. “If we make (the Fairmount American Legion) a non-smoking post we’ll probably lose it.”

While Hochstetler empathizes with Spears, she said Grant County needs to put health first.

“My dad was a vet from WWII and I totally understand the issue of ... the government telling me what I can or cannot do and it conflicts with me,” Hochstetler said. “I get that, but there are so many other areas like OSHA (Occupational Safety and Health Administration) where many of our workplaces would not be completely safe if we didn’t have OSHA helping us.”

For smokers who are looking to quit, one option is the 1-800-QUIT-NOW line, Hochstetler said.

“They will counsel with people online or on the phone and help people get the medication if they want to quit,” she said.

Vaping considered unsafe option

Today the biggest entrants into the nicotine market are e-cigarettes and vape pens, but while seemingly a better alternative to cigarettes, their marketing is deceptive.

According to Hochstetler, tobacco drops tar into smokers lungs, which leads to chronic obstructive pulmonary disease, emphysema and lung cancer.

While vaping devices don’t drop tar into your lungs, they do contain nicotine.

“On the front label it (may) say zero milligrams of nicotine, then you turn it on the backside and it says it has nicotine in it,” Hochstetler said. “Labels are not regulated right now on the juices or the liquid.”

Names for vape juices often sound like candy, too. One company has juices named “shortcake,” “gummy” and “rainbow.”

Early studies have shown vaping can contribute to seizures and popcorn lung as well, Hochstetler said.

According to the American Lung Association, popcorn lung is the scarring of small air sacs in the lungs, resulting in the thickening and narrowing of airways.

The disease arose in May 2000 when workers in a popcorn factory reported respiratory issues. The culprit was found to be diacetyl, used then as a popcorn flavoring. Major popcorn manufacturers banned the chemical, but it has since cropped up in some e-cigarette vapors.

“There are between 60 and 80 chemicals in every single one of those liquids that you heat,” Hochstetler said. “We have no idea the impact of those heated chemicals on the body. It’s just so new. It always takes awhile for the health care data to catch up to what the effect is.”

According to Hochstetler, many young people in Grant County are claiming they regularly see their friends vaping, even at school and on the bus.

“If anybody wants to have someone (from MGH) come and speak about vaping or tobacco contact (us),” she added. “We would love to get out and talk to people."

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