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How providers are assisting their patients with smoking cessation

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Deshler, Adam
Huebscher, Roxana
MS, Nursing
May 13, 2009
Cigarette smokers -- Psychology; Smoking cessation -- Psychological aspects; Smoking cessation programs; Health promotion
Smoking leads to the death of approximately 440,000 Americans per year. Smoking deaths would be prevented if smoking cessation could be embraced. The Department of Health and Human Services (HHS) updated its guidelines on smoking cessation in 2008, focusing on a framework of 5-As: Ask, Advise, Assess, Assist, and Arrange. These steps currently represent best practice for helping smoking patients to achieve cessation. Since the update in 2008, HHS recommends 3 things for providers regarding smoking cessation: brief counseling, medications (prescription and nonprescription), and referred counseling. This study explored how providers assist their patients with smoking cessation within the context of the HHS smoking cessation guidelines. The Stages of Change Model developed by Prochaska and DiClemente (1995) is the theoretical framework for the study. When providers are assisting their patients with smoking cessation, they are moving them from a state of Preparation to a state of Action. If HHS guidelines are used, the smoker can progress from the Action phase to the Maintenance phase. The researcher used a Likert scale survey. A convenience sample of primary care health providers was obtained from a healthcare organization in the Midwest. The nurse practitioners (NPs) and physician assistants (PAs) were issued a researcher-developed survey via the internet. Data analysis consisted of descriptive statistics. All of the participants who answered the demographic questions were female, with all but one stating that they were a NP. While some participants had smoked in the past, none were current smokers. Most had practiced between 0 and 4 years and 10 and 14 years. The 2 primary focuses of practice listed were internal medicine and family practice. The number of responses per question ranged from 48 to 44. There were 3 Likert questions, each addressing brief counseling, referred counseling, and medications. Analysis of the data showed that providers were in compliance with the guidelines. The results show the highest compliance was with brief counseling and the least amount of compliance with referred counseling. Over 60% of the participants had not read the 2008 update to the smoking cessation guidelines. There are several implications that can be ascertained from the study. The first is developing a system that allows a provider to easily disseminate guidelines that affect their practice. The second is developing methods that allow a provider to efficiently provide referred counseling to their patients who smoke.
A Clinical Paper Submitted In Partial Fulfillment of the Requirements For the Degree of Master of Science in Nursing Family Nurse Practitioner
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