President Obama: Personal Health Report (October 2011)
RWJLHS: President Obama's 2011 health report states that he is "tobacco free". I am trying to understand what this term actually means. As a layperson, can I assume the president has kicked the habit?
Yes, I would interpret that tobacco free indicates he is no longer using any tobacco products. The terms that you might hear could be: Smoke-free – this would imply no use of any combustible tobacco products (cigarettes, cigars, pipe, hookah?) Tobacco-free – this would imply no use of ANY tobacco products (all of the above PLUS smokeless tobacco – chew, snuff, snus, dissolvable tobacco, etc). Some very new products are still open to debate – such as electronic cigarettes. The FDA has classified these as tobacco, but they really aren’t in the traditional use. Nicotine-free – this term, not used much, would imply NO intake of nicotine. So, that would include ALL of the above PLUS no use of “medicinal nicotine” otherwise known as nicotine replacement therapies (NRT’s) – patch, gum, lozenge, nasal spray, oral inhaler.
RWJLHS: Would a physician interpret "tobacco free" differently than a layperson? If so, how?
Hopefully not. They should all be using the above definitions.
RWJLHS: Can someone chew tobacco and be considered tobacco free?
Hope that the above answers this. They would be smoke-free but not tobacco free.
RWJLHS: What about e-cigarettes?
See above. These products actually produce a nicotine/propylene glycol vapor…even though it LOOKS like smoke, it is not smoke. Problem is that these products are entirely unregulated by the FDA so we don’t really know what is in them or how much nicotine they deliver. They are classified as tobacco products by the FDA but no action has been taken as of yet on them. New Jersey does not allow use of e-cigarettes in areas covered under the Clean Indoor Air Law of 2006.
RWJHLS: What about a nicotine patch?
As above, nicotine patch is ONLY nicotine, and none of the 7000 other toxins found in tobacco smoke. It is an FDA approved pharmaceutical that is approved for smoking cessation. Nicotine itself has very few harmful effects on the body.
RWJHLS: As a physican yourself, is there a follow-up question on the tobacco free topic that you would like to ask President Obama's physician?
How was he able to successfully stop using tobacco? Can we more broadly publicize his success so others could benefit from his example? Can we mandate coverage for tobacco treatment so others could benefit? Is he still using any NRT’s?
Dr. Michael Steinberg, MD, MPH, is Associate Professor of Medicine at the Rutgers University- Robert Wood Johnson Medical School (RWJMS) and Director of the Tobacco Dependence Program. Dr. Steinberg has devoted his clinical and research careers to treating tobacco dependence. The Tobacco Dependence Program (www.tobaccoprogram.org) has treated nearly 6,000 smokers since 2001, and has trained over 1,500 health professionals as Tobacco Treatment Specialists. Dr. Steinberg’s ongoing research includes over 40 peer-reviewed publications on various tobacco treatment interventions and studies of healthcare provider practices. Contact: email@example.com