When 6-year-old Evelyn Levesque’s grandfather Gary Scheyd died at 58 of lung cancer in 2008, she didn’t understand what was happening.

Once she got more involved with the American Cancer Society Cancer Action Network and the Tobacco 21 Law along with her father, Roger, in 2017, she said he explained, “You have a personal connection to Tobacco 21…You have a reason to want this and to support this. He told me how my grandfather started (smoking) when he was young and he was never able to quit. Inevitably, the smoking caught up to him and that was exactly why he got lung cancer and passed away.”

“Tobacco use remains the leading cause of preventable death in the U.S., a fact that though shared widely is often surprising and sobering to people in our country,” ACS CAN President Lisa LaCasse wrote in her Oct. 2 blog at fightcancer.org.

“Tobacco is associated with lots of diseases, things like heart disease, other forms of vascular disease, stroke, cancer,” said Dr. Jennifer Worth, a thoracic surgeon with Hartford HealthCare Medical Group in Norwich.

Knowing that people continue to die from smoking and seeing tobacco companies target young people with vaping products that feature special colors, smoking tricks and flavors (such as cotton candy, bubblegum, mint and menthol) “is extremely frustrating,” Levesque, now 18, said during a telephone interview.

Plus, she said students are not being educated in school about the dangers of tobacco products, because there is no longer any money in the state budget for this purpose — something that Levesque, her father and ACS CAN are working to change.

Levesque said she has seen a number of students sent to the hospital due to injuries from smoking e-cigarettes. One of her friend’s lung collapsed and he was in the hospital for a few weeks.

“They’re just overusing them, because they’re being advertised as the healthy product that they’re just not,” she said. “They’re being falsely advertised, so nobody understands how truly dangerous they are.”

“It is concerning that vaping is on the rise, particularly in younger age ranges. The big concern is that these are not federally regulated substances, so we are not fully aware of everything that is inside them,” said Worth.

She added that “addiction is a very difficult thing to overcome” and that it takes some individuals five or six times to successfully quit smoking.

“I very much encourage as a society to not condemn people who are smokers. With my patients, I just try to be supportive and encouraging,” she said.

Worth said there also seems to be some risk associated with high secondhand smoke exposure and developing cancer.

How to quit

Worth pointed to numerous strategies a smoker can use to quit smoking, including nicotine patches/gum “to help you wean and then stop,” as well as one-on-one and group support counseling.

For some people, quitting is like flipping a switch, she said, adding that individuals need to find their reasons for quitting.

“Sometimes people recommend replacing one habit with another,” she said. “You hear tricks about things like people sucking on Dum Dums (or other candy) after your meal instead of having a cigarette.”

Also, Worth suggested replacing the deep drag of a cigarette with taking a deep breath of oxygen.

“You may find that you get that sense of calm and peace that you would otherwise get if you were actually smoking,” she said.

Hartford HealthCare offers smoking cessation services to its patients.

“Each individual person needs to figure out what works for them and how to do it and to keep trying and to know just because you have failed before or been too scared to try before, doesn’t mean that you might not be successful in the future,” Worth said.

Reasons for lung cancer

Worth said there is much doctors don’t understand about lung cancer and that it’s possible to get cancer whether you smoke or not.

“Certainly, there is an association with smoking,” she said. “So if you are a smoker, cutting back or quitting is important.”

According to the American Cancer Society, “People who smoke are about 25 times more likely to develop lung cancer than nonsmokers,” and “About 81 percent of deaths from lung cancer are

still caused by smoking.”

There is also a strong association between radon and cancer.

“It’s important to test for radon in your home and use mitigation if your radon levels are elevated,” Worth said. She urges people to live a healthy lifestyle by eating properly and exercising to prevent other chronic diseases, which “will hopefully help you prevent any cancer in general.”

Everyone should not be screened for lung cancer, she said.

“There are specific guidelines that have been developed by the centers for Medicare and Medicaid Services and then each insurance company has their own slight variation to that,” she said.

In general, to be considered as a lung cancer screening candidate, one has to have a significant smoking history and be between 55 and 75.

The fact that you can get lung cancer without smoking, yet you can’t get tested for lung cancer unless you are a smoker is a “definite weakness or loophole in our current treatment program,” Worth said.

The problem is that in general, people who have lung cancer don’t have symptoms, she said so it’s difficult from a medical perspective to determine the best way to screen people. Currently, CT scans “are the only screening modality” and there are some risks associated with them, including radiation that your body receives.

“As a medical community, we do not want to subject everyone to a CT scan,” she said. “So that’s why right now, we’re taking the population that is considered the most high risk. It doesn’t address other people who could develop lung cancer one day.”

Hopefully, screenings will become more widespread as other strategies are developed, she said, “like we have now with mammograms, for example, for breast cancer or colonoscopies for colon cancer.”

Generally, lung cancer doctors are identifying lung cancer at earlier stages and treating it more effectively so that people can survive longer, said Worth, who has specialized in minimally invasive robotic lung cancer surgeries for the last 10 years.

“In medicine, we get more CT scans more frequently for example,” she said, “so things are found incidentally … so then we’re able to intervene. Also, there have been a lot of advancements with drug development and chemotherapy, and specifically, the immunologic agents.”

Plus, because the camera on the robot magnifies 10 times, she said she can see better, which allows her to be more effective in her operations.

Worth said she uses the term “robot” loosely, as she is really the robot.

“I am the one that is using it. You can think of the robot as basically an extension of my arm and the tools that I am able to use with that actually move in more angles than my hands or wrists are able to normally so I can operate more precisely,” she said.

She said lung cancer is a difficult disease.

“It is a scary diagnosis, but we’re really here to help and work together. We’ve got a great multi-disciplinary cancer treatment team,” she said.

Worth said they review each patient’s films and pathology and decide the best approach to improve each individual’s outcome, which might be a study protocol, chemotherapy and/or surgery.

“In general, people are surviving with lung cancer longer and outcomes are much better than they were 10 years ago,” she said.

For more information about Hartford HealthCare Medical Group in Norwich, call 860-425-5305. For smoking cessation programs, call 800-QUIT-NOW (800-784-8669) or visit the Connecticut Department of Public Health’s website at portal.ct.gov/DPH.

In October 2019, Connecticut passed the Tobacco 21 Law, increasing the age of sale for tobacco products from 18 to 21. It joined 15 other states that passed similar legislation. Then, on Dec. 20, 2019, President Donald Trump signed a bill making it a federal law.

Jan Tormay is a longtime former Norwich resident now living in Westerly.