Peer-to-peer

Ray McKelligott took two drags of a “snipe” cigarette after months of not smoking, and moments later was in the hospital, his heart failing. It was a nearly impossible habit to kick after almost 30 years puffing two packs a day.

“Skull and crossbones, baby,” he said. “Two drags—boom, I was gone. That’s how deadly cigarettes are.”

McKelligott, who’s also been diagnosed with paranoid schizophrenia, now maintains the strength to stay healthy by encouraging others who desire to quit, serving as a peer advocate at Butte County Behavioral Health’s The Hub in Paradise and facilitating a smoking cessation group held noon-1 p.m. every Thursday.

Health professionals have found programs led by former smokers-turned-advocates to be a vital part of an effort to decrease smoking rates among disenfranchised populations, including those with mental illness.

McKelligott has now been smoke-free for two years. “I’m so grateful,” he said. “Everybody’s story helps me. It keeps me connected and away from cigarettes.”

About 25 percent of adults in America have a mental illness or substance use disorder, yet they consume nearly 40 percent of all cigarettes smoked by adults, according to the Centers for Disease Control and Prevention.

Further studies indicate people with severe mental illness die 10 to 25 years younger on average, according to research highlighted by the World Health Organization and National Alliance on Mental Illness. The most common causes of death among this population? Heart and lung disease and cancer, the CDC states, all of which are often caused by cigarettes.

This caught the attention of Dr. Chad Morris, director of University of Colorado’s Behavioral Health & Wellness Program. He’s devoted years of his life to helping disenfranchised groups around the country quit, developing educational materials for health professionals and working with hospitals and governments to enact policy change.

Morris, who visited Chico last year, said the issue is ultimately one of social justice: “We know the majority of those smoking with mental health issues want to quit, but they aren’t afforded the same opportunities,” he said. “They’re asking for treatment; they’re not getting it.”

In Butte County, support meetings are held at The Hub and Iversen Wellness & Recovery Center in Chico weekly, local hospitals occasionally offer classes, and there’s a state helpline: 1-800-NO-BUTTS. Butte County Public Health received $72,000 from the recently increased state tobacco tax, spokeswoman Lisa Almaguer said, and is looking for an agency that can provide more cessation resources for at least three years, with a launch date set for July 1.

Bruce Baldwin, cessation coordinator for the California Health Collaborative’s Chico office, said ideally the county will get to a place where anybody who decides to quit will be able to call or go online and have immediate access to locally staffed tobacco cessation support groups and services.

“I understand how much it costs, and it takes a lot of work,” he said. “Now it’s kind of the folks that need the most help to quit are the ones who are left.”

Colorado has seen favorable results by treating tobacco cessation as a standard of care, Morris said. Smoking prevalence among mentally ill residents decreased from about 33 percent to 27 percent between 2012 and 2015, according to University of Colorado’s Community Epidemiology & Program Evaluation Group.

“If you look at any major behavioral changes in people’s lives, whether they’re trying to lose weight or they’re just trying to be healthier, [to] quit smoking, it’s very hard to do it alone,” Morris said. “So you really do need that social support system.”

Last month at a support group meeting, Baldwin, McKelligott, fellow peer advocate Paul Avila and former smoker Lisa Febbo discussed progress and recovery.

Febbo smoked for 38 years, she said, and after quitting about a year ago, her symptoms from emphysema were greatly reduced and her throat nodules disappeared. The motivation for her, like for McKelligott, was health-based: She couldn’t stop picturing herself with a hole in her throat or bed-ridden, tubes like tendrils connected to her body.

“Plus, I was embarrassed all the time because I’d have these coughing attacks, and I’d have to carry water and a rag for me to cough in everywhere I’d go,” she said. “I just keep telling myself, ‘You can’t go back now.’ That’s the reason I come to these groups—it helps me stay away from it.”

Avila confessed that he is still struggling—during one attempt to stop smoking, he chewed on toothpicks for a year. Though this helped satiate cravings, he eventually turned back to cigars after wood shavings became lodged in his throat.

Now, he’s down to four a week, compared to two packs of cigarettes a day before he started attending the support group classes at The Hub.

“The psychological stuff is really tough,” he said. Just two puffs makes him feel less anxious or agitated. “Every week, I get two to three days under my belt, then I pick it back up. So, I’m trying to get past that point.”

The group clapped for Avila, celebrating the small victory and lifting his spirits. “You gotta give yourself some credit,” McKelligott said.

“It’s just like people that have an eating disorder, a drug disorder, an alcohol disorder. It’s all disordered, and addiction is a disease,” Febbo said later. “We’re all around each other, we’ve got to support each other.”