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Smoking secession project 2023
Dorit halelouyan
DH-305
A Brief Background on the Patient
A 42-year-old Caucasian male has been smoking for 20 years. His job as
a salesman sells man is very demanding and stressful for him, which fuels his
smoking habit. Concurrently, the high-pressure environment of being a salesman
frequently triggers his smoking habit. He has been smoking 10 cigarettes everyday
since he was seventeen years old. For the past 6 months he decided to try vaping as a
healthier alternative. Nonetheless, the continued use of nicotine and the possible
health hazards of vaping make this transition worrisome. The patient mentioned that
he has made previous attempts to quit smoking about 4 years ago. At some point he
wasn’t able to sleep well and had a hard time, obesity was an additional factor to this.
He decided to stop smoking all of a sudden from smoking 10 cigarettes a day to zero
cigarettes per day. He didn’t follow any specific strategies. He could only do it for 3
days after that he could’t hold himself anymore. So he failed quit smoking, which I
completely underestand because that wasn’t the right way to quit smoking from 10
cigarettes to 0 all of a sudden after smoking for 20 years, so it was unsuccessful. This
suggests that quitting smoking has been a challenging endeavor for him in the past,
but now wants to quit smoking due to health issues and family obligations. He just
had a daughter about 10 months ago. Tailoring an effective smoking cessation strategy
for him requires understanding his background and motivations for smoking. This will
ensure that the strategy addresses both his physical dependence on nicotine and the
psychological and environmental factors that contribute to his smoking habit.
I revised the plan for quitting smoking in light of his comments and the
difficulties he had. Nicotine gum was my first choice when it came to helping him
kick the habit. Since he is a busy person and under a lot of stress as he mentioned, I
thought chewing gum can help with stress and also helping him for not wanting to
smoking as much at the same time. Hartmann-Boyce et al. (2018) remarks, “All of the
commercially available forms of nicotine replacement therapy (NRT), i.e. gum,
transdermal patch, nasal spray, inhalator, oral spray, lozenge and sublingual tablet, are
effective as part of a strategy to promote smoking cessation. They increase the rate of
long term quitting by approximately 50% to 60%, regardless of setting. These
conclusions apply to smokers who are motivated to quit”. The convenience
and control it offers in terms of nicotine dosage were major factors in his decision to
use this gum, as he has a long history of dependence on the drug. Also, if you’re
having trouble physically quitting smoking, you might find that chewing gum is a
‐
good oral alternative to vaping. Both Hartmann-Boyce et al. (2018) and Lindson et al.
(2019) found that nicotine replacement therapies helped people quit smoking for
good, so this approach makes sense.
In addition to nicotine gum, I highly advised my patient to speak with a
counselor which will help him build a trustworthy relationship which will allow him
to break behavioral habits and find comforting substitutes. Counseling is a great way
to be in the presence of someone who is empathetic and will give non-judgmental
advice which will be a key factor in effectively addressing both the initial hesitation
and difficulty my patient has experienced as part of his quitting process. The smoking
cessation counselor can set progressive goals and build his confidence. As stated in
the article, Adult Smoking Cessation—The Use of E-Cigarettes, concluded that,
“Smoking cessation medications approved by the U.S. Food and Drug Administration
(FDA) and behavioral counseling are effective treatments for quitting smoking,
particularly when used in combination”. It was clear that his smoking habit was
influenced by the stress he felt from his demanding job as a sells man and in addition
to his new fatherly duties. His stress management skills were enhanced through the
incorporation of techniques like mindfulness, deep breathing exercises, and time
management strategies. Research by Robinson et al. (2019) lends credence to this
strategy by highlighting the need for behavioral support alongside pharmaceutical aids
for effective smoking cessation. I hoped that by addressing the psychological and
physiological components of his smoking addiction with nicotine gum and
individualized stress management techniques, I could increase his chances of
successfully quitting.
I came up with a two-pronged strategy that centered on education and support
to help his smoking cessation plan work. Providing the patient with extensive
educational materials was the foundation of my plan. I printed out some informational
brochures and gave them to him; they were well-thought-out and straightforward. For
the sake of his own health and that of his young daughter, as well as countless others,
this pamphlet detailed the many advantages of giving up smoking. Managing cravings
and withdrawal symptoms with nicotine gum correctly requires following the
instructions carefully, which were included in the package (Cains et al., 2004). Also
included in the brochure was information on stress management strategies that he
could use to deal with his unique set of problems, including pressures at work and the
adjustment to fatherhood. Mindfulness meditation, deep breathing exercises, and
advice on how to strike a balance between work and personal life were all part of the
package.
This process took about a months. I started checking in with him at regular intervals
meaning twice a week to see how he is doing, because I knew that staying motivated
and holding accountable would be a huge help when trying to quit smoking. We were
talking about any problems he was facing and what was discussed with his councilor
and how much he was able to follow at each sessions. Then make any necessary
adjustments to his cessation plan. During these sessions, I encouraged him and offered
emotional support by going over his reasons for quitting and the advantages of
remaining tobacco-free in the long run. To make sure he felt supported and heard
throughout this difficult process, the check-ins gave him a chance to talk about his
experiences, both good and bad. To help him overcome his nicotine addiction and
make substantial progress towards a healthier lifestyle, a combination of educational
materials and continuing support was created.
Several important activities were involved in putting the smoking cessation
plan with him into action. I told him about nicotine gum and how it could help him
control his cravings for nicotine so he could quit smoking. With this, I gave him a
well-organized pamphlet that explained the risks of smoking and vaping, the
advantages of giving up the habit, and some helpful hints for things like stress
management and nicotine gum. I also started keeping track of the progress every
week. The purpose of these meetings was to check in on his progress toward his
cessation goals, address any concerns he may have, and reward him for his efforts.
Achieved results: Increasing the patient’s awareness of the dangers of smoking
and vaping was a major accomplishment of this project. An important milestone on
his path to quitting was this heightened awareness. An important step toward kicking
his vaping habit was when he began using nicotine gum as directed.
Difficulties: Notwithstanding these achievements, difficulties did arise. Most notably,
he had trouble using the nicotine gum on a consistent basis. His inability to kick his
long-term vaping habit meant he was inconsistent with his gum use, which reduced its
efficacy.
Contemplation: Looking back on these results, I see that nicotine replacement was an
important part of the smoking cessation program, but that he could have benefited
more from a focus on stress management, since that is a major factor that triggers his
smoking. If I could go back in time and do it all over again, I would make it a priority
to address the mental health components of smoking addiction by incorporating stress
management strategies and looking into extra support groups or therapy. Taking a
more all-encompassing approach has the ability to increase the chances of
successfully quitting smoking and the frequency with which cessation aids like
nicotine gum are used.
Methods for Enhancement
After giving his smoking cessation plan some thought, I came up with two main
suggestions for how to make future attempts even more successful: better support and
better ways to deal with stress.
Improvements in Support: While the weekly check-ins were helpful, they also
highlighted a need for additional support on a more regular and varied basis. In order
to make this part better, I might think about making our one-on-one check-ins more
often, particularly when you’re first trying to quit smoking and the urge to smoke is
strongest. Incorporating the patient into a support group may also help him feel more
connected to others and encourage him to reach his goals. When you’re in a group like
this, you can talk to people who understand what you’re going through and get advice
on how to handle tough times. It is possible that his motivation and dedication to
quitting could be greatly enhanced by the shared experiences and mutual
understanding within such a group.
The results indicated a need for more extensive and effective stress-relief activities,
although the original plan emphasized the significance of stress management in
helping smokers quit. The next time I work with him, I will make sure to incorporate a
variety of stress management techniques that are specific to his needs and preferences.
Examples of such pursuits include trying out a new hobby, going to a guided
meditation class, or practicing yoga. I would also recommend organized methods of
time management to help him strike a better work-life balance and alleviate stress. An
additional asset to his quit attempt could be connecting him with stress management
experts, like therapists or counselors, or providing him with resources for selfmanagement.
I aim to tackle his smoking habit more comprehensively by strengthening his support
system and introducing more effective stress-relief activities. By making these
changes, we can improve the chances of a successful long-term outcome and make the
cessation process more sustainable.
In adults that use vape does prescription nicotine replacement therapies versus using
over the counter replacement therapies affect smoking outcomes?
Pico Analysis:
P: (Population): My patient is a 42 year old Caucasian male who has smoked a pack
a day for 25 years since when he was seventeen year-old and decided to try vaping as
a healthier alternative.
I: (Intervention Methods): The prescription nicotine intervention therapies that I
would suggest is Nicotine gums and talking to counselor.
C: (Comparison between methods): The over-the-counter replacement therapies that
I would recommend is Nicotine gum
O: (Expected outcome): Increasing the patient’s awareness of the dangers of
smoking and vaping was a major accomplishment of this project. Hopefully it can
help him quit.
References
Hartmann-Boyce, J., Chepkin, S. C., Ye, W., Bullen, C., & Lancaster, T. (2018).
Nicotine replacement therapy versus control for smoking cessation. The Cochrane
Database of Systematic Reviews, 5(5), CD000146. https://doi.org/
10.1002/14651858.CD000146.pub5
Lindson, N., Klemperer, E., Hong, B., Ordóñez-Mena, J. M., & Aveyard, P. (2019).
Smoking reduction interventions for smoking cessation. The Cochrane Database of
Systematic Reviews, 9(9), CD013183. https://doi.org/
10.1002/14651858.CD013183.pub2
Robinson, J., McEwen, A., Heah, R., & Papadakis, S. (2019). A ‘Cut-Down-To-Stop’
intervention for smokers who find it hard to quit: a qualitative evaluation. BMC
Public Health, 19(1), 403. https://doi.org/10.1186/s12889-019-6738-9
Lee, P. N., & Fariss, M. W. (2017). A systematic review of possible serious adverse
health effects of nicotine replacement therapy. Retrieved from https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC5364244/
Cains, T., Cannata, S., Poulos, R., Ferson, M. J., & Stewart, B. W. (2004).
Designated “no smoking” areas provide from partial to no protection from
environmental tobacco smoke. Tobacco Control, 13(1), 17-22.
A Summary Of Smoking Cessation: A Report Of The Surgeon General -2020 Adult
Smoking Cessation – The Use of E-Cigarettes. Retrieved from https://www.cdc.gov/
tobacco/data_statistics/sgr/2020-smoking-cessation/fact-sheets/pdfs/adult-smokingcessation-e-cigarettes-use-h.pdf (https://www.cdc.gov/tobacco/data_statistics/sgr/
2020-smoking-cessation/fact-sheets/pdfs/adult-smoking-cessation-e-cigarettes-useh.pdf)