Hospital smoking cessation programs and healthcare provider interventions

¶ … Incidence of Lung Cancer in Women

The work of Humphrey, Teutsch and Johnson states that the leading cause of cancer-related death in the United States and throughout the entire world is lung cancer. (2007) Research findings state evidence that women are much more likely to develop lung cancer than are men. There is a critical need to develop an intervention program that is successful in assisting women to quit smoking. The work of Denny, et al. (2002) entitled: "Hospital Initiatives in Promoting Smoking Cessation: A Survey of Internet and Hospital-Based Programs Targeted at Consumers" reports a conducted to assess "how often local U.S. hospital provide smoking cessation information in the following two ways: via Hospital Web sites; and via routing incoming phone calls to their hospital switchboard to an in-house smoking cessation clinic." (2002) Results of this study show that "among hospital Web sites surveyed, only 30% contained information relating to smoking cessation programs. The phone survey of hospital switchboards show that 47% had a smoking cessation program available via phone inquiry, while 53% did not." (Denny et al., 2002) it is stated by Denny et al. (2002) that of the 50 million individuals who smoke in the United States, 20 million attempt to quit smoking each year but only a mere 6% actually succeed. While over two-thirds of smokers desire to quit smoking, yet only 50% report a hospital or physician having asked whether they smoke and if they desire to quit smoking with even less being given advice on how to successfully cease smoking. A "...significant number of smokers come from lower socioeconomic groups..." (Denny et al., 2002)

TARGET POPULATION and SETTING

The target population in this study is health care providers. The work of David S. Blumenthal entitled: "Barriers to the Provision of Smoking Cessation Services Reported by Clinicians in Underserved Communities" states that: "...although physicians often advise their smoking patients to quit, they frequently fail to provide cessation assistance." (2007) Moreover, "Women, ethnic minorities, and Medicaid and uninsured patients are less likely to receive appropriate cessation services, even though such services are effective among these groups." (Blumenthal, 2007) Barriers to provision of smoking cessation services have been identified by physicians to include "...lack of awareness, lack of familiarity, disagreement, lack of self-efficacy, and inability to overcome the inertia of previous practice." (Blumenthal, 2007) Another identified gap is "the absence of studies using qualitative methods" as the majority of medical literature has been reliant on "quantitative methods in which results are expressed as numbers or rates." (Blumenthal, 2007) the value of qualitative research in this area is stated to be due to "results are presented descriptively, and they are particularly valuable in answering 'how' and 'why' questions and in shedding light on attitudes, behaviors, perception and culture." (Blumenthal, 2007)

PURPOSE of the STUDY

The purpose of this research is to provide an intervention or campaign to provide resources to PCPs aimed at increasing their smoking cessation assessment skills or an educational program for PCPs to enable them to better recognize the stages of change and to provide a screening tool for PCPs to facilitate their identification of smoking women patients who are ready to quit smoking.

II. THEORETICAL FRAMEWORK/DISCUSSION

THE INTERVENTION

The intervention in this study will be the formulation and implementation of a screening tool for lung cancer for women who smoke by PCPs and furthermore to assist healthcare providers in gaining the knowledge and confidence to provide smoking cessation counseling to their patients. The most important risk factor for lung cancer is stated to be cigarette smoking. As a matter of fact, 87% of all lung, bronchial and tracheal cancer is attributed to smoking." (Humphrey, Teutsch, and Johnson, 2007) p. 1

IMPLEMENTATION

The current screening regime in the United States is practically nonexistent. (Humphrey, Teutsch, and Johnson, 2007) Crane states that the "...fundamentalist clinical goal is to achieve cessation before the onset of serious disease." p.117 Crane additionally relates that "physicians play an important role in encouraging the transformation from nicotine addict to recovering ex-addict." p.118 Implementation will be in PCPs office who serves low-income women who are also smokers who desire to quit or who have never been presented with the possibility of assistance to quit smoking. This intervention will assist healthcare providers in gaining the necessary knowledge and confidence to offer this smoking cessation counseling to their patients.

IV. EVALUATION

HEALTH POLICY IMPLICATIONS

The initial costs for implementation of this screening tool are relatively little as initially the PCPs will provide women who smoke with the information and knowledge that there are supports in ceasing to smoke. If health care plans presently offered treatment for smoking cessation the result would be that more women would have access to health care provider counseling. Furthermore, if healthcare providers felt more knowledgeable and confident in their counseling skills they would more likely assess and counsel their female patients who smoke.

ACCESS, QUALITY, COST

Healthcare provider counseling cost between $700 and $2,000 per year of life saved compared to the many thousands spent to treat lung cancer with only a 15% 5-year survival rate. The amount saved by this intervention is astronomical when comparing healthcare provider counseling vs. lung cancer treatment. Moreover, assistance to individuals in ceasing to smoke potentially save the lives of many women who would otherwise continue to smoke until afflicted by lung cancer or some of life-threatening and debilitating disease.

V. CONCLUSION

Adoption and implementation of a cancer screening tool in the form of physician counseling concerning cessation of smoking for those who smoke is an intervention that is promising in assisting many smokers to stop smoking thereby prolonging their life and improving their quality of life.