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Tobacco use is the leading cause of preventable death in the United States. Smoking is linked to emphysema, heart disease and cancer and has been reported to kill an estimated 438,000 Americans yearly. Smoking is also a risk factor for a host of other illnesses such as congestive heart failure, asthma, pneumonia, stroke, reduced fertility in women, poor pregnancy outcomes, breast cancer, cataracts, and macular degeneration.
An evidence-based tobacco cessation program was implemented in a small rural hospital in Northeast Florida to improve the outcomes of patients, employees and families. At baseline, smokers averaged 23.8%, versus the statewide average of 19.3% and despite a Healthy People 2010 goal of 12% or less. According to a State Behavioral Risk Factor Report, non-smoking adults exposed to second hand smoke was 16.6% compared to a statewide average of 14.9%.
When patients are hospitalized and are in close contact with health professionals who can provide tobacco-cessation information, their chances for considering quitting is increased. Patients are focused on their health and are more likely to be motivated to change unhealthy behaviors during hospitalization, especially if it is an irritant or contributor to their admitting condition. Inpatient settings provide opportunities to target smokers when they are away from daily cues associated with smoking. They are thinking about their health and possibly more motivated to change their behavior than when healthy and out of the hospital or likely to have already stopped smoking (temporarily) because they feel too ill. Those who lack medical insurance and regular access to preventive services might not seek help in quitting. By providing on-site counseling, a significant number of employees as well as patients have made efforts to quit. Also, preliminary results show a reduction in readmissions for patients with chronic illnesses who have been counseled during their inpatient admissions.
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