health promotion plan

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Tobacco Cessation Plan

John Doe

Capella University

NURS4060

Some Month, 2020

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Tobacco Cessation Plan

This paper will outline a comprehensive plan for a tobacco cessation plan for the 55 to

76-year-old population. Evidence has proven the use of tobacco and tobacco related products

have both negative and even detrimental effects to one’s health. Over the years laws for the

usage of cigarettes has heightened along with policies and laws surrounding the use of tobacco

products in public.

The Data

According to Golechha (2016) tobacco smoking is one of the greatest causes of mortality

in the world and while tobacco smoking accounts for over five million preventable deaths each

year surprisingly, nearly one billion people are still smoking and the number grows each year.

The relationship between tobacco smoking and vascular disease is well known. Golecha (2016)

advises smoking causing health problems to include vascular diseases like coronary heart

disease, artery hardening, and stroke as well as respiratory diseases such as pneumonia, chronic

obstructive pulmonary disease, and even cancer. Other problems like high blood pressure, oral

and esophageal concerns, as well has gastrointestinal malfunctions also develop secondary due to

smoking.

A campaign strategy or plan for health promotion is crucial to help combat the degree of

mortality that still exists around the world due to smoking and second hand smoking. Second-

hand smoke is the byproduct from a smokers lungs upon exhale and is believed to carry as much

toxic particles as the initial inhale of a cigarette. Public awareness is the first step in enhancing

knowledge and providing education and useful resources to prevent the smoking habit from

forming as well as encouraging smoking cessation. It’s evident that the same amount of energy

should be used for smoking prevention as it is spent on smoking cessation. As hard of a task as

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both may seem a movement in general is needed towards preventing conditions before they are

developed and before health problems or comorbidities worsen.

Health Promotion Plan for Smokers

Health promotion initiatives and effective policies have been placed to help eliminate

tobacco usage. According to Golechha (2016) health promotion methods to include the taxation

of smoking, mass advertising campaigns in the media, peer education programs, community

mobilization, motivational interviewing, health warnings on tobacco products, marketing

restrictions, and banning smoking in public places are efforts to combat tobacco users and

manufactures. Bright and Burdett (2019) highlight the unawareness patients previously

possessed early on because they were not aware of the future detrimental effects smoking would

have on their health.

According to Park et al. (2015) lung cancer is the leading cause of cancer death in the

U.S. and cigarette smoking is the culprit for 87% of lung cancer deaths. Park et al. (2015)

correlates the 30 pack-year smoking history to an estimated 8.6 million adults whose age ranges

from 55 to 76 years old. The patient’s 55 or older most likely grew up breathing cigarette smoke

and most likely started smoking because they were influenced by a family member or friend.

The specific population’s age range is between 55 and 76 years old and is dedicated tobacco

smokers. This population was chosen because of the strict reinforce and awareness that is

needed regarding the destructive effects of smoking. Since this age group grew up either

smoking or around people that did lung compliance and frequent physical exams are vital for

preventative health.

The smokers between the age of 55 and 76 years old have a different knowledge base that

new younger smokers that have recently picked up the habit today. The 55 to 76 year old

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generation grew up seeing ashtrays in restaurants even before there was a “smoking or non-

smoking” side. Cigarette and tobacco users existed as the majority versus the minority because

of a vast lack of knowledge, minimal federal regulations on cigarettes and the ingredients within,

as well as the convenience of it being accepted or “the normal” out in public. According to

Joseph et al. (2018) some studies report smokers in older ages may suggest resistance to smoker

intervention while other data reports that patients undergoing lung cancer screening are

interested in quitting with evidence of successful treatment. Joseph et al. (2018) compares

younger smokers to older smokers and advises that older smokers are known to hold unique

beliefs regarding the harms of smoking, their personal ability to quit successfully, and the

benefits of quitting.

Smoking cessation treatment can be offered through material, medication, support

groups, and contact information to quit lines. According to Park et al. (2015) the US Public

Health Service established guidelines recommending that advice to quit and brief counseling be

offered at all, or nearly all, office visits to their primary care provider. Although these guidelines

are set in place it is rare many physicians press the importance of smoking cessation or offer

guidance on how to make lifestyle changes. Park et al. (2015) advises that brief screenings

should be attempted by the primary clinician and should include the “5As”: ask, advise, assess,

assist, and arrange follow-up and although 1 in 5 smokers are willing to make a serious attempt

to quit smoking the help of treatment that incorporates evidence-based counseling and some

pharmacologic intervention is rarely offered.

Health Disparities and Barriers

Disparities exist for people that are trying to quit. According to Chandler (2020) people

with lower education levels, those with lower incomes, racial and ethnic minorities, older adults,

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and rural populations are less likely than other to try and quit smoking each year. Efforts are

focused on meeting the needs of these groups through the increase to access to health insurance

coverage for cessation treatment with reduced copayments. Chandler (2020) reports to better

reach the disparities of the group health care coverage limits have been eliminated for smokers,

text messages and the internet is used to enhance the engagement of smokers in cessation

treatment while embedding interventions into a variety of health care environments. Some

patients might not have access to text messages or the internet therefore, community health

centers and behavioral health treatment facilities might be a better option.

It’s Time to Quit

John Smith is a 67-year old male that has been smoking since he was 17. He typically

smokes a half of pack of cigarettes a day and buys them by the carton because he has limited

access to transportation. He tried to quit smoking once before after his heart attack at the age of

57 but got discouraged and started feeling depressed so he picked the habit back up again. He

admits that he would like to attempt to quit smoking again because he has a new great grand

child that he wants to see grow up.

Mr. Smith has limited access to transportation but lives close to a bus stop so community

resources are identified to help with a support group for tobacco cessation. Pharmaceutical

options exist in the form of help with an anti-depressant and medicine to reverse the dependency

on smoking by decreasing the amount of use each day. His first goal is to create a plan of action

that outlines a day to cease from smoking and what avenues he will visit versus smoking a

cigarette. Each day he will decrease his cigarette use by one. Habits usually exist for smokers

like when and where they chose to smoke. Instead of waking up and going straight for a

cigarette he will drink a glass of water, read some of his motivational quitting materials, prepare

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breakfast, refrain from smoking a cigarette as long as possible. Nicotine gum and patches can be

used to help combat the urge. Mr. Smith has a cell phone that receives text messages and alerts

will be sent to remind him of the plan he has chosen and advice on how to stay tobacco free. He

will attend at least two meetings a week that are hosted by a non-profit organization and both are

free of charge to him. Since he started having symptoms of depression a follow-up appointment

with his physician will be made after the first week of smoking cessation. The follow-up will

address current needs of Mr. Smith and will allow time to evaluate his plan and make

adjustments.

Conclusion

It's important that our patients are ready to quit smoking. This information can be

discovered during his assessment. Evaluating what Mr. Smith knows about smoking as well as

what his limitations are, and what resources he needs will help establish his goals so that they are

attainable. The focus and treatment should be tailored to his preference and worked at a pace

that he is comfortable with. Reversing his habits that he has acquired is difficult, that is why we

have to work hard to replace those habits with things that are healthy and beneficial to his health.

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References

Bright, T., & Burdett, T. (2019). Smoking cessation and the health promotion role of community

nurses. Journal of Community Nursing, 33(4), 56-60. Retrieved from:

https://search-proquest-com.library.capella.edu/docview/2272758222?pq-

origsite=summon

Chandler, A. (2020, February 4). Re: https://sph.washington.edu/news-events/news/us-smoking-

rate-dropping-disparities-cessation-reinforce-need-public-health-action

Golechha, M. (2016). Health promotion methods for smoking prevention and cessation: A

comprehensive review of effectiveness and the way forward.International Journal of

Preventive Medicine, 7(1), 7-7. doi:10.4103/2008-7802.173797

Joseph, A. M., Rothman, A. J., Almirall, D., Begnaud, A., Chiles, C., Cinciripini, P. M., . . .

Vock, D. M. (2018). Lung cancer screening and smoking cessation clinical trials. SCALE

(smoking cessation within the context of lung cancer screening) collaboration.American

Journal of Respiratory and Critical Care Medicine, 197(2), 172-182.

doi:10.1164/rccm.201705-0909CI

Park, E. R., Gareen, I. F., Japuntich, S., Lennes, I., Hyland, K., DeMello, S., . . . Rigotti, N. A.

(2015). Primary care provider-delivered smoking cessation interventions and smoking

cessation among participants in the national lung screening trial. JAMA Internal

Medicine, 175(9), 1509-1516. doi:10.1001/jamainternmed.2015.2391

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