Hollings expands Tobacco Treatment Program to Columbia

When she graduated from the University of South Carolina, Catie Tuori, Pharm.D., never imagined she would be back in Columbia so soon – no longer as a student but as a clinical pharmacy specialist helping people to quit smoking.

“I love this city so when I had the chance to come back and build something new here, I had to take it. It feels like coming full circle,” she said.

At MUSC Hollings Cancer Center, pharmacists are an integral part of the multidisciplinary team that helps patients to quit smoking, vaping and using tobacco products through its Tobacco Treatment Program, giving patients the evidence-based tools and emotional and physical support to beat addiction. The program has long had a telehealth option to reach people across the state, but the expansion into Columbia means that Midlands residents can now meet with tobacco treatment specialists in person.

The expansion also allows Hollings to achieve its mission of meeting the needs of patients across South Carolina. Hollings launched the Tobacco Treatment Program in 2014 with a single pharmacist in Charleston among the staff. Tobacco use is the leading cause of preventable death in the U.S. For people with cancer, it can be especially harmful, interfering with treatment, slowing healing and worsening long-term outcomes.

“Tobacco use negatively impacts every organ system in the body, so helping people quit is critical no matter what health issue they’re facing – but especially cancer,” said Emily Ware, Pharm.D., a clinical pharmacy specialist in the Tobacco Treatment Program and director of MUSC Health’s Ambulatory Care Pharmacy Residency Program.

Today, the program staffs three clinical pharmacists – Ware and Amanda Forrest, Pharm.D., in Charleston and Tuori in Columbia – in addition to five certified tobacco treatment specialists. Despite their distance, the pharmacists stay closely connected, sharing daily updates, clinical questions and success stories.

“The addition of Catie to our Tobacco Treatment Program team really facilitates our access in the Midlands and helps us to meet our statewide mission of preventing cancers through tobacco cessation,” said Benjamin Toll, Ph.D., director of the Tobacco Treatment Program.

Tuori now leads tobacco treatment services at an MUSC site in Columbia, where she is working to build connections with local providers and introduce Hollings’ approach to comprehensive, pharmacist-led tobacco cessation.

“In Charleston, providers are used to working closely with pharmacists,” Tuori said. “Here, it’s been important to show what we can do – spending the time with patients that busy doctors may not have and helping people take the steps toward quitting.”

"We always say there are two sides to the coin. Nicotine replacement helps with the physical dependence, but long-term success comes from tackling the behavioral habits and life triggers that drive tobacco use.”

Emily Ware, Pharm.D.

Tuori sees patients from across the Midlands and beyond, including rural communities and a few from out of state. About 40% of her visits are in person, with the rest conducted virtually. Telehealth makes it easier for patients – especially those balancing cancer care with fatigue or nausea, transportation challenges or long commutes – to stick with treatment.

“The in-person appointments tend to go longer because patients really value that face-to-face time,” she said. “But even virtually connecting with someone who understands what they’re going through makes a big difference. It opens so many more doors to getting visits.”

Tuori, Ware and Forrest are part of an interprofessional team that includes clinicians, researchers, counselors, psychiatrists and more.

“We’re the drug experts, but we rely on our colleagues for behavioral support,” Forrest said. “Each of us brings expertise to the table; it’s the best model for patient care.”

Tuori and Forrest recently completed intensive tobacco treatment specialist training, which deepened their expertise in evidence-based behavioral approaches, such as pharmacotherapy, cognitive behavioral therapy, motivational interviewing and relapse prevention.

“The training added another layer to my background,” Tuori explained. “It gives me the tools to understand what’s leading patients to smoke and how to help them stop.”

“It’s about unlearning a habit that’s been part of someone’s daily life for 20, 30, even 40 years. That takes time and support.”

Amanda Forrest, Pharm.D.

The training also prepared them to address both the physical and emotional sides of smoking – a cornerstone of tobacco treatment at Hollings.

“We always say there are two sides to the coin,” Ware said. “Nicotine replacement helps with the physical dependence, but long-term success comes from tackling the behavioral habits and life triggers that drive tobacco use.”

That treatment combines medication with harm reduction strategies in the form of nicotine patches, gums and lozenges. It also involves counseling strategies, such as “urge surfing” through cravings, finding substitutes like cinnamon sticks to replace the hand-to-mouth habit of smoking or vaping and learning new ways to handle stress.

“It’s about unlearning a habit that’s been part of someone’s daily life for 20, 30, even 40 years,” Forrest said. “That takes time and support.”

That support is individualized, and progress is celebrated – whether a patient quits entirely or simply cuts down.

“We don’t expect patients to quit overnight,” Tuori said. “One cigarette less a day still means 7,000 fewer chemicals in the body. We celebrate even that small win.”

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