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South Central Wisconsin Tobacco Free Coalition hosted David Macmaster to speak to Juneau County residents at Mauston High school on Nov. 6. Macmaster is the cofounder of the Wisconsin Nicotine Treatment Integration Project, also known as WiNTiP.

Macmaster emphasized that tobacco addiction should be approached and treated like other harmful substance addictions, such as alcohol or drugs.

“There still isn’t any significant training in tobacco addiction,” Macmaster said.

Macmaster said that there is Alcoholics Anonymous for alcohol addiction and similar support programs for drug addiction, but those suffering from tobacco addiction have historically been left out. This can be counterproductive.

“I’ve had several people over the years who started smoking when they went to treatment for alcohol and drug abuse,” Macmaster said.

Macmaster’s presentation noted that tobacco addiction can be especially prevalent among individuals who are “African American, American Indian/Alaska Native, Asian American/Pacific Islander/Hawaiian, LGBT, low socio-economic status, (and) adults with mental health and substance use disorders.”

According to materials provided at the event, in 2014 there were 7,356 tobacco related deaths in Wisconsin. Which was higher than the 1,529 alcohol related deaths and the 873 drug related deaths. By those figures, tobacco related deaths would account for 75.38 percent of the total substance abuse deaths in Wisconsin for 2014.

The presentation also reported that more than 75 percent of individuals in treatment for substance use disorders smoke, and that when individuals quit tobacco and other substances at the same time, they are 25 percent more likely to stay off both.

The Centers for Disease Control and Prevention report that in Wisconsin, the percentage of adults who smoke cigarettes is 20.9 percent. But the recent 2016 community health assessment found Juneau County to be higher than Wisconsin more generally, at 27-28 percent. Four out of five Juneau County residents agreed or strongly agreed to knowing people who used to tobacco. The assessment also found that one in four pregnant mothers in Juneau County had smoked while pregnant, more than double the state average. The assessment was made in collaboration with the Central Wisconsin Health Partnership.

Macmaster said the prevalent acceptance of tobacco use can make it more difficult for organizations to approach tobacco addiction like other substance addictions. “They’re reluctant to start a tobacco program, because they might lose business or referrals,” Macmaster said, alluding to the possibility of smokers choosing to go to smoking friendly businesses and organizations rather than anti-smoking ones.

Several of Macmaster’s former colleagues were tobacco users themselves.

“It was part of what they were used to (for) their whole career,” Macmaster said

Macmaster made arguments for what he calls “the case for tobacco integration.” The integration of tobacco addiction into the list of formally recognized substance addictions, and receive comparable resources for fighting the prevalence of tobacco addiction.

Macmaster noted that it is common for both specialists and tobacco users to view tobacco addiction differently than other substance addictions.

“You ask them if they’re addicts, ‘no, we’re not like those alcoholics and drug addicts,’” Macmaster said.

At one point during the presentation, Macmaster asked the audience if they had lost someone to lung cancer or a tobacco related illness. He estimated about half of the audience had raised their hands.

You can reach Jake Ekdahl on Twitter @JakeaEkdahl