Change Talk and Choice: Options for Tobacco Cessation in Primary Care

Saturday, 7 November 2015

Virginia G. Massey-Holt, MSN, RN, NP-C1
Joanie Jackson, DNP, APRN, FNP-BC1
Jenny M. Holcombe, PhD1
Anthony V. Dallas, MD2
Thomas H. Cook, PhD, RN, FNP3
(1)School of Nursing, University of Tennessee at Chattanooga, Chattanooga, TN, USA
(2)CareHere, Brentwood, TN, USA
(3)School of Nursing, Vanderbilt University, Nashville, TN, USA

Purpose of Project: This project seeks to answer the question of: in primary care providers, how does implementation of a tobacco cessation (TC) protocol and TC counseling training (to include Motivational Interviewing, or MI), when compared to current practice, effect knowledge of MI, PCP self-efficacy of TC counseling, and incidence of brief TC counseling over three months?

Poster presentation: This poster presentation will demonstrate the implementation of a Doctor of Nursing Practice translational project. Additionally, it will provide an overview of current recommendations for tobacco cessation and tobacco cessation counseling in the primary care setting. 

Background information: Despite the known dangers of smoking, Tennessee continues to have a higher than national average of adult smokers (23 to 18.1%) and that 69% of them would like to quit (CDC, 2012 and 2011).  Primary care providers (PCPs) are in a key position to have to have motivational conversations to help patients make a quit attempt and to be successful. However, due to demands of time and limited resources, PCPs may be reluctant to do so. Review of literature indicates that providing training for PCPs can increase the self-efficacy for performing tobacco cessatio counseling, knowledge of skills for and incidence of tobacco cessation counseling. 

Description: This Doctor of Nursing Practice translational project will analyze current tobacco cessation counseling incidence and practice. A tobacco cessation protocol and Motivational Interviewing (MI) training will be offered to Middle Tennessee PCPs in a clinic system. Tobacco cessation counseling self-efficacy and MI knowledge will be assessed pre-, post-intervention and at project conclusion. Tobacco cessation counseling incidence and practice will be measured at 30 and 90 days and compared to baseline.

Outcomes: In a practice of 6,000 patients, there is potential to positively interact with the estimated 1,380 smokers. By effectively employing a tobacco cessation protocol and using the spirit of Motivational Interviewing, PCPs will have the opportunity to transform their practice. 

Impact: Through this project, we are poised to broaden the body of known nursing knowledge in regard to tobacco cessation protocols and Motivational Interviewing training for use in the primary care setting.