Tobacco Cessation

In the United States, smoking cigarettes is the number one preventable cause of morbidity and death (Bergen, 1999), and accounts for $300 Billion in health care costs and economic productivity loss (Jamal, 2015). While the national smoking rate is 16.8% (CDC, 2016), specific demographics are more susceptible to developing smoking habits: people who live below the poverty line (10.9% higher), disabled or with a limitation (6.2% higher), and males (4.7% higher) (Agaku, 2014).

Healthy People 2020 is a movement in America which was started in 1979 and provides 10 year national objectives based on science for promoting health and preventing diseases. It sets and monitors health objectives and tries to influence individuals to make informed health decisions. With such kind of objectives, smoking becomes a big health concern to Healthy People 2020. Smoking affects national health and causes health disparities. Smoking has been associated with a number of health complications such as cancer and heart diseases. Under Healthy People 2010 issues such as smoking during pregnancy and cigarette smoking cessation were to be addressed.

Of the roughly 42 million adults in the US that use tobacco, nearly 69% of smokers want to quit and more than 42% of those wishing to quit will make the attempt through various methods(1). These methods range from the "cold turkey" method, nicotine replacement therapy, behavioural therapy and even medicine. Each method has it's unique strengths and weaknesses as well as varying success rates. There are many reasons to quit and many ways in which to do so, either with methods that involve slowly weaning off of nicotine, like gums and patches from replacement therapy, to nicotine-free methods which require support from various sources.

CVS is the first the first national pharmacy chain store to ban tobacco and focus on the health and well-being of its patients and customers (Drell, 2014). This is a nationwide initiative, however, it doesn’t immediate solve the problem, but it is a step in the right direction. In light of CVS’s removal of all tobacco products from its shelves, the drugstore chain plans to offer its customers robust smoking cessation programs (Drell, 2014). The target public is the heavy tobacco users—the age range differs but it includes both men and women.

And results from previous studies indicate that different groups of smokers would have different outcomes in health, and health disparities in smoking cessation exist among smokers currently. Researchers investigate these disparities by race, gender, socioeconomic status, insurance status and so on. Racial/ethnic health disparities is one of the major disparities that researchers found. Compared with non-Hispanic Whites, racial/ethnic minorities are less likely to quit smoking successfully. 1-3. In particular, smokers who are African Americans and Hispanics/Latinos are less likely to be provided advices about smoking cessation by health care providers than non-Hispanic Whites,1 and Hispanic/Latino smokers face more barriers when they attempt to quit smoking.2 Barriers to quitting smoking not only decrease the success rate of smoking cessation for smokers, but it also aggravate disparities among smokers. Undoubtedly, smoking cessation services and advices that provided by health care providers help smokers to quit smoking more successful compared with smokers who rely smoking cessation on themselves. And lack of advice from health care providers increase the failure rate of smoking

The leading cause of death in the county is heart disease followed by cancer, and both of these can be linked to smoking or second-hand smoke exposure. Methods to move toward HP2020’s goal will involve encouraging and assisting smokers to quit. The Community Guide is a free resource to help guide communities to choose programs and policies for cessation. These programs are evidenced based, research-tested and include suggestions such as increasing the unit based price on tobacco products and how this would help to decrease use, increase the number of those who quit, decrease the number of those who try cigarettes the first time and decrease the tobacco related morbidity and mortality. The research suggest the improved health effects are proportional to the size of the price increase, also noted to be effective in prevention is mass reach communication or advertising regarding the dangers of smoking and also techniques for quitting (The Community guide, n.d.). Counseling is noted to be effective alone and with the use of medications and is available through programs like the toll-free quitline in South Carolina. Healthcare professional are urged to screen patients for use of tobacco and provide cessation information to all patients and also treatment strategies such as

Smoking is still a pressing issue for Americans, despite efforts to regulate and lessen tobacco use. One in every five Americans still regularly smokes a cigarette, and those who attempt to quit aren’t utilizing all the assistance resources available to them. With these treatments being more prominent now than ever before, there is evidence that supports the effects of a quitter using aid compared to one who does not. Providing brief interventions about tobacco cessation may encourage more quit attempts and use of appropriate treatments, such as a quit-lines or medication. Despite many efforts, healthcare providers are still failing to provide brief interventions to patients, which therefore exposes flaws in a healthcare-based strategy to drive

Nicotine dependence remains a significant public health concern (Rep., 2011). Cigarette smoking is the leading preventable cause of mortality in the United States, accounting for approximately 1 out of every 5 deaths. On average, smokers die 13 to 14 years earlier than nonsmokers. Additionally the estimates for average annual smoking-attributable productivity losses are $96.8 billion and the total economic burden of smoking is approximately $193 billion per year (USDoHaH, 2000). Despite the availability of therapeutic options for smoking cessation, relapse rates remain high (Piasecki, 2006; Pollak et al., 2007). Therefore, there is a need for new, effective, strategies to assist cigarette smokers achieve abstinence.

One of the Healthy People 2020 objectives is to promote health and to reduce chronic disease risks. A concern that correlates with my chosen vulnerable population of homeless people and is relevant to them is tobacco use. Taylor et al. (2016) maintain that 75 % of homeless people smoke cigarettes. Therefore, I am choosing the objective number, TU-4.1 “Increase smoking cessation attempts by adult smokers” (U.S. Department of Health and Human Services, 2016, pare 4). This objective states that half of the people who smoke have made an attempt to quit smoking in the last year. And I believe it is appropriate for this vulnerable population because the survey revealed that great deal of the interviewed people rate their health as not good enough and were willing to try to change it by altering the risk factors. To stop this growing epidemic, Healthy People 2020 has put a system of strategies in play that will help ensure that people willing to make a change can get the help they need to achieve their goal. Community health nurse can help achieve this objective and make this goal happen by providing education and implementing interventions to teach the homeless people and help them quit

This study was limited to students who self-identified themselves as never-smokers. Never-smokers were those who answered “I’ve never smoked cigarettes” to the question “Now think about 12 months ago. At this time last year, about how much were you smoking?” Independent variables being used in this study included age, gender, and SHS Exposure in cars and homes as probed by the survey questions as presented in the 2011-2012 CSTS:

“Telephone quitline counseling is effective with diverse populations and has broad reach. Therefore, both clinicians and health care delivery systems should ensure patient access to quitlines and promote quitline use” (https://www.tobaccofreekids.org/research/factsheets/pdf/0245.pdf)

In the lifetime of most, cigarette smoking is common occurrence noticed as you go throughout your community. In the medical setting, hospital professions see the disabling effects caused by smoking. Being a change agent in your society is necessary for enhancing the well-being of others through each community. Healthy People 2020 creates a goal to “reduce illness, disability, and death related to tobacco use and secondhand smoke exposure” (2017) Seeing the effects of smoking in the medical setting it motivates professionals to educate our patients’ on smoking cessation. For the topic of this research, our group was motivated by understanding how well our education paid off and whether we were able to find more control in smoking

Linnan and Steckler (2002) describe the following key process evaluation components: Context-aspects of the larger social environment that may affect implementation; Reach-the proportion of the intended audience to whom the program is actually delivered; Dose-delivered-The amount of intended units of each program component that is delivered; Dose-received-the extent to which participants engage with the program; Fidelity-the extent to which the intervention was delivered as intended ( Bartholomew et al., 2011. p.526).

Smoking is an addiction that risks one’s health which in turn can lead to death. As time advances, both smokers and non-smokers have begun understand the harm in this deadly habit as it doesn’t only affect the smokers, but anyone who encounters second-hand smoke. Since people have become aware of the health risks of smoking, cessation tools such as nicotine replacement therapy were invented to help cigarette smokers terminate their desires to smoke. As technology improves, smoking tools are created, like the electronic cigarette (e-cigarette) that was invented in 2003 (Rahman, Hann, Wilson, & Worrall-Carter, 2014). Electronic cigarettes can deliver low doses of nicotine to ease withdrawal symptoms. Furthermore, as electronic cigarettes increase in popularity the question arises if these devices can be used for smoking cessation purposes like nicotine replacement therapy (NRT). After discussing the topics of e-cigarettes and smoking cessation, one will conclude that electronic cigarettes can be compared to nicotine replacement therapy as a successful quitting method. Furthermore, the use of electronic cigarettes can be an effective method of smoking cessation.

According the Centers for Disease Control and Prevention (2015), cigarette smoking is the leading cause of preventable disease and death in the United States, accounting for more than 480,000 deaths every year, or 1 of every five deaths. In 2015, about 15 of every 100 U.S. adults age 18 years or older currently smoke cigarettes. However, this is a decline from nearly 21 of every 100 adults back in 2005. One reason for the decline is due to smoking cessation programs developed within our communities. These programs are helping smokers to quit their habit, and improve their health and lifestyle. Let us look at what it takes to make a smoke cessation successful within ones’ community.