Abstract
Purpose: The purpose of the project was to implement and evaluate a smoking cessation program to include: provider/staff education (Office Champion model); pharmacological therapy; and behavioral health therapy that was individualized for male and female participants, aged 19 and older within the primary care clinic located at Columbus Medical Center in Columbus, NE.|Background: In Nebraska 18.4%/245,000 adults, over the age of 18, currently smoke. Among this population, 2,300 Nebraskans aged > 35 years of age die per year from tobacco, i.e. the 7th highest cause of death in the state. This is a significant issue for a rural provider's practice in Columbus, Nebraska. A current working smoking cessation program does not exist in this clinic and the provider supported a smoking cessation intervention program.|Methods: The design of the smoking cessation program was a Quality Improvement Project.|Sample: Male and female, 19 and older, with a Nebraska area code, were patients within the provider practice.|Procedures: Referral from the provider, consent obtained followed by a stage of change assessment and the Fagerström Test for Nicotine Dependence. The P.I. provided education to the participant based on the two brochures and the Krames patient education handout. Based on the results of the assessment tools the P.I. completed the Nebraska Tobacco Quitline referral form for the patient. A prescription by the provider was individualized for the participant.|Results: During the time of 10/25/2017 to 1/28/2018, 60 tobacco users came into the clinic while the PI was present. Out of that many, 14 were seen by the PI and 7 referrals were sent out to the Quitline along with 9 prescriptions sent to a pharmacy. The average amount of time sent with each patient was 9.6 minutes.|Discussion: After evaluating the findings of this study, three topics of discussion came up. Some resistance seen with the Quitline/behavioral health interventions was seen. Time is very limited and important to PCP when it comes to their patients. Finally, policies make a difference in behavior change.|Conclusion: Smoking is one of the most preventable social activities leading to death with 20 million smoking related deaths in America over the last 50 years. With a smoking cessation program needed at the Columbus Medical Center, the provider and staff were engaged with the implementation of the office of champions' model using Nola Pender's. With using these models, Fargerstroms Nicotine Dependency test and the Stages of Changes score were used to assess each patient, all of which helped to bring positive results and a successful smoking cessation program.