| Learning Objective #1: Discuss various strategies of designing, implementing, and measuring outcomes of an individualized smoke cessation program based on tobacco cessation guidelines | |||
| Learning Objective #2: Understand different smoke cessation strategies available for promoting tobacco abstinence: a) What works and what doesn't; b) The ongoing process of relapse and success |
The purpose of this presentation is to describe the development and implementation of an individualized smoke cessation program for medically indigent patients in “the heart of Dixie” - tobacco country. Smokers use tobacco for many different reasons and where there is smoke, there is significant disease, addiction, and eventual suffering.
Many of the low-income, underserved patients enrolled in this asthma/COPD clinic have significant tobacco usage. Initially tobacco cessation was discussed at each visit with all smokers were given a verbal challenge to cut back. This intervention alone resulted in a 25% decrease in the number of cigarettes used. Over the last year, patients were invited to participate in an individualized smoke cessation program (n=30, ). Every advantage for success was provided for those enrolled. Nicotine supplementation, Bupropion SR, behavioral modification techniques, a resource book, and “a new habit” hands on bag were utilized during the program. An individualized approach allowed for identification and understanding of why patients smoked. Once reasons were identified then individual strategies were devised to help overcome stress, specific emotions elicited during withdrawl, weight gain, etc.
Smoking is a chronic disease, with periods of success and/or relapse. During the past year, the clinic experienced a 50 – 80% non-smoking rate, with only 10 – 15% becoming smokers on a daily basis again. Even with relapse, patients have remained at .5 ppd or less (initial usage 1 - 5 ppd). Tobacco usage contributes to multiple disease processes, a decrease in the number of cigarettes smoked improves health and decreases risks. Total abstinence of course is the goal, resulting finally from multiple attempts. Nurses can make a difference in decreasing the amount of tobacco used by an individual with a clear reminder to cut back. With individualized strategies and multiple interventions, greater success and lasting abstinence can occur.
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