Yale employees looking to stop smoking may have been turning to University Health Services, which ostensibly offers a smoking cessation program. What some of these employees found, however, is that this program does not exist — and a pilot to jump-start such a program ended weeks ago. Lawrence Gipson reports.

David Estep, who runs security in Bass Library during the night shift, has been an “on-off” smoker for the past 20 years. His clinician at Yale told him he should quit, but Estep was never encouraged to join a University-run smoking cessation program — because none existed.

Estep recently quit on Aug. 31, not because of anything Yale had done but because he wanted to.

“I didn’t even think about Yale,” Estep said. “I just knew I had to quit. This was something I did by myself, for me.”

Out of the 10 Yale employees interviewed who smoke, seven said they do not plan to quit. But for those who want to stop smoking — for those who actively seek advice from their doctors — Yale’s resources come up short. Yale University Health Services advertises a smoking cessation program for employees in its member handbook, but the program does not actually exist, Director of University Health Services Paul Genecin acknowledged. While there was a pilot smoking cessation program in place for six months this year, it has not been renewed, said Patricia Stumps, assistant director of clinical studies at YUHS.

And although Genecin expressed hope that Yale would eventually offer a comprehensive program — as Harvard, Princeton and other universities do — even the future of other pilot programs is uncertain.

‘Everyone smokes’

Lucia Greig has been a Yale employee for six years and a smoker for four years. She runs through about a pack a day. Greig said she knows she will not be a smoker her entire life. When she quits, she explained, it will be a definitive move on her part.

At the same time, she has never made a concerted effort to quit. A YUHS employee has never spoken to her about her habit.

“Have I heard about the dangers of smoking?” Greig asked. “Nope. Not from Yale. You hear it all over the place, but never from Yale.”

A majority of the Yale employees interviewed estimated that around half of their coworkers are smokers. When asked how many people she works with who smoke, Greig answered with two words: “Everyone smokes.”

A security guard who wished to remain anonymous expressed skepticism as to whether Yale should even be involved in advising employees on personal health issues.

“I’m not sure that’s the employer’s job,” he said. “To my mind, it’s up to the individual to make the effort to quit.”

Estep added that he feels strongly responsible for his own smoking habits, as do many others who work for Yale.

Stumps, who was in charge of Yale’s smoking cessation pilot program, said YUHS is attempting to educate Yale employees about the risks of smoking. All YUHS employees encourage current smokers to quit, she added.

Stumps said YUHS makes available “extensive informational resources” about smoking risks to those on the health plan, including information on YUHS’s Web site, newsletters, talks with clincians and occasional informational fairs. The links and quit-smoking hotlines on YUHS’s Web site are all from organizations outside the University, Stumps said, and the number of bazaars advertising the dangers of smoking vary from year to year.

She also said she is uncertain about how many Yale employees receive these newsletters.

Mixed messages

On page 24 of the Yale Health Plan Member Handbook, “smoking cessation” is clearly listed as one of the programs offered through the Office of Health Promotion and Education. When the News called the department, however, an employee told the News that it did not offer any such programs.

“No formal program [to quit smoking] exists right now,” said the YUHS representative, who spoke on the condition of anonymity.

In contrast, when the News contacted health services at Princeton and Harvard universities to ask about their smoking cessation policies, employees at both places responded with information about group-help sessions or individual counseling that would start within a week. Each representative said the program was available to anyone with a university health plan.

Princeton health services even offered free nicotine patches.

Harvard’s health services Web site includes a phone number to contact a nurse educator and get information about smoking cessation options, lists books about quitting smoking available in Harvard’s library and gives the location for employees to pick up free “Quit Kits.” An online newsletter from Princeton University Health Services describes a comprehensive six-week smoking cessation program and lists the time and location of the next smoking cessation group.

Yale’s smoking cessation Web site features sections entitled “Why should I quit?” and “Ways to quit.” It also advises smokers on improving their chances of quitting by finding “the right approach, support and tools that will work for you.” Further down the page, the Web site gives several phone numbers and links to informational Web sites — none of them sponsored by the University.

‘Large-scale pilots’

When asked about YUHS’s current policy with regards to smoking, Genecin admitted that Yale lacks a concrete program.

“The University does not offer a smoking cessation program for staff at Yale,” Genecin said. “We are running a pilot to scope out [the best options].”

In fact, Stumps said, the pilot program, which began last spring, recently ended. Stumps said she could not recall the exact number of people who participated, but she said the pilot program placed a small subgroup of Yale employees who wanted to quit smoking in a number of one-on-one sessions with their YUHS clinicians.

“The most important [resource in quitting] is a patient’s relationship with their primary care provider,” Stumps said.

Of the Yale employees interviewed — seven of whom were told by their YUHS doctor about the dangers of smoking — only one quit based on advice from his clinician.

Genecin simply said he did not know why YUHS lacked the comprehensive, organized smoking cessation programs offered by Princeton and Harvard to all University staff.

“I think it’s a department that hasn’t been fully developed,” Genecin said. “I do think it’s a worthy thing to be doing.”

Genecin said YUHS hopes to budget several large-scale pilots in areas of the University where smoking is especially prevalent. Stumps said that there are no concrete plans for a future pilot program, although she hopes there will be a few more implemented in the near future.

Researchers at Yale are currently looking into the use of the medication naltrexone to help smokers quit without gaining weight. Participation in this experimental program is open to the general public.

But until a better solution is developed, butting out may continue to fall squarely on Estep’s shoulders.