Tobacco Cessation Amongst the Underserved
Danielle Klement, Kimberly Turgeon, Chrystal Armstead, Caroline Pinnix, Eva Formackova
Bon Secours Memorial College of Nursing
Description of the Issue
Macro level:
According to the CDC, smoking tobacco is the leading cause of
preventable death in the United States. There are currently
millions of Americans who have at least one disease related to
smoking. Bon Secours Virginia currently has a no nicotine policy
for its applicants. Smoking tobacco is a problem within the Bon
Secours Virginia population because it creates health problems
for the individuals, leading to various negative effects on the
community.
Micro level:
Bon Secours Care-A-Van serves approximately 5,307 patients in
Richmond, Virginia. Out of those patients, 686 or 12.4% smoke
tobacco. Implementing a tobacco cessation intervention will
promote the following outcomes:
• Decrease the number of the patients developing chronic
diseases related to smoking such as lung cancer, COPD, and
emphysema.
• Reduction in hospital visits and emergency room utilization
• Increase in health promotion activities to include individual
and environment health promoting healthy patient outcomes.
Root Cause
Research shows that most smokers begin during their
teens due to being surrounded by peers/family members
and tobacco smoke through peer pressure, etc. Tobacco
marketing (TV, movies, social media) can play a big role.
Youth/ young adults are vulnerable and impressionable at
this age and this might make them feel accepted among
their peers. Once they start smoking, addiction sets in
and they continue to smoke due to stress and other
environmental factors (American Cancer Society, 2019).
Analysis of the Issue Solution
• Age
Smoking cessation champion for a peer-led support group.
• Prevention efforts should focus on young adults ages 18-25 years old. Almost no
one starts smoking after age 25, 9 out of 10 smokers started smoking by age 18. Hypothesis: Implementation of smoking cessation support groups led by a peer
(Department of Health and Human Services, n.d.) who has successfully quit smoking at the Bon Secours Care-A-Van will create an
• Peers overall 20% decrease in the number of cigarettes per day per person.
• Youth identify with peers they see as social leaders and they imitate their behaviors. Evidence: People who have gone through the same thing and successfully quit
They also want to fit in and tobacco marketing make smoking look appealing to this have a higher credibility than healthcare staff. This would make a peer mediated
population. (Department of Health and Human Services, n.d.) support group a highly cost-effective way to provide quitting assistance to people
• Environment who smoke in populations with high smoking prevalence. (Ford, Clifford, Gussy,
& Gartner, 2013).
• Youth who are exposed to smoking in movies/media they are more likely to smoke.
(Department of Health and Human Services, n.d.)
• Current smokers still smoke for various reasons including relaxation, habit,
addiction, weight, management, and stress relief. (Why do people smoke?, n.d.)
• Resources
• Space changes based on location of the Care-A-Van since it varies everyday.
• Staffing would include a smoking cessation champion, healthcare professionals, and
additional administrative personnel to collect and consolidate the data.
• Education and training for the champion and administrative personnel.
• Creation of pre-, mid-, and post-questionnaires and a quality improvement survey
•
References
American Cancer Society. (2019). Why People Start Smoking and Why It’s Hard to Stop.
Retrieved from https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/why-people-
start-using-tobacco.html
Department of Health and Human Services.(n.d.). Preventing Tobacco Use Among Youth and
Young Adults: A Report of the Surgeon General. Retrieved from
https://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/index.html
Extinguishing the Tobacco Epidemic in Virginia | CDC. (n.d.). Retrieved from
https://www.cdc.gov/tobacco/about/osh/state-fact-sheets/virginia/index.html
Ford, P., Clifford, A., Gussy, K., & Gartner, C. (2013). A Systematic Review of Peer-Support
Programs for Smoking Cessation in Disadvantaged Groups. International Journal of
Environmental Research and Public Health. doi:10.3390
Why do people smoke? (n.d.). Retrieved February 18, 2019, from
https://www.helptoquit.com.au/smoking-facts/why-do-people-smoke