Tobacco Cessation Training Program - Assignment Example

? Tobacco Cessation Training Program Keller Army Community Hospital Alexander Heatrice DDS Joseph Marino DDS, FAGD Jeffrey Chaffin DDS, MPH A.T. Still University Oct 3, 2013 Tobacco Cessation Training Program Implementation of tobacco cessation programs as one of the major public health preventive measures has gained limited success in reducing the number of people involved in tobacco use with statistics showing that about 23.7 million adult Americans are still involved in the habit (CDC, 2013). As such, similar percentages are at risk of diseases such as chronic respiratory diseases, lung cancer, and heart diseases as well as dental conditions (Lee et al., 2011). Despite the implementation of tobacco cessation programs in schools and the community level, an estimated 50.8 of students of smoked only stopped smoking for a single day (CDC, 2013). According to CDC, out of the people who expressed the desire to stop the use of tobacco, about 52 percent of the adults could only stop for a day in 2009. Failure by such programs to achieve significant impact in reducing tobacco use can be attributed to several barriers to the effective implementation of cessation programs including limited knowledge about the various health risks associated with the habit, misinformed perceptions about such programs and limited training on the various ways of quitting (Lee et al., 2011). In line with efforts to enhance the effectiveness and outcomes of tobacco cessation programs, researchers have proposed several measures among them creation of education and creation of awareness among individuals willing to quit the behavior. As such, the practicum was intended to increase the content of existing tobacco cessation programs through inclusion of an education on oral health risks and benefits for the cessation, training on how to quit, and awareness creation component to boost participation and the eventual outcomes of the project. Previous studies have suggested that limited content in the existing tobacco cessation programs contribute to poor participation and outcomes ( Ask. Advise. Refer. Org, n.d). Lack of education on the potential oral health risks associated with tobacco use, poor training on ways of quitting the habit and lack of support from health professional in the public health sector significantly influences the capacity of the affected people to participate in the such programs as well as the ability to successfully quit the habit. Problem Statement The main problem leading to the project was identified as the continued limited impact of tobacco cessation programs in reducing tobacco use and helping individual willing to quit the habit to do so as result of lack education on potential oral health risks, poor training, and poor perception about the programs. For instance, a survey conducted by CDC in 2009 indicated that about 52 percent of adults willing to quit smoking only stopped the habit for a single day with a 50.8 percent of high school students indulging in the smoking habit being able to quit for the same period. According to Hopkins et al. (2001), despite the increased information and implementation of the cessation programs, tobacco use has remained steady with the prevalence among adults estimated to be 24.1%. Evaluation of existing tobacco use cessation programs revealed that limited participation and poor outcomes could be attributed to lack of education on the oral health risks associated with the habit, poor perceptions about the programs at the community level, inadequate training on quitting strategies and insufficient support from the healthcare practitioners (CDC, 2013). Objectives and Goals The main objective in the project was to evaluate the suggested impact of including a component of educating individuals willing to stop using tobacco on their perception and participation in tobacco cessation programs. The achievement of these objectives was determined through the change in the number of people willing to participate in the cessation programs and the change with number of people with a positive attitude about the programs after implementation of the proposed educational component. The outcome of the program was to be determined by the number of individual completely quitting tobacco use after six months of participation in the programs. The goal was to demonstrate the importance of sufficient content in achieving improved participation and outcomes of tobacco cessation programs. Review The use of tobacco has been associated with several oral health risks that most people are not aware of including oral cancers such as throat cancer, periodontal diseases, and tooth decay (Petersen, Bourgeosis, Ogawa, Estupinan-Day & Ndiaye, 2005). Lung cancer which is strongly associated with tobacco use accounted for about 171, 840 deaths in the United States in the year 2008 (Mong et al., 2011). The number of lung cancer deaths reduced slightly in 2009 in which 159, 000 deaths were recorded showing the slight impact of efforts such tobacco cessation programs in addressing conditions associated with tobacco use (Mong et al., 2011). It is estimated that about 85% of lung cancer cases are attributable to direct or second hand smoke (Mong et al., 2011). In a study conducted to the knowledge about health risks associated with tobacco use among the highly educated people, results revealed that most of the participants had wrong perception about the risks of tobacco use (Peiper, Stone, Van Zyl & Rodu, 2010). This clearly demonstrated that even the educated professionals need better education about risks associated with tobacco use to change their perception about the habit. According to Petersen, Bourgeosis, Ogawa, Estupinan-Day and Ndiaye (2005), Oral diseases such as periodontal diseases, dental caries , tooth loss, oropharyngeal cancers, oral mucosal lesions and orodental trauma associated with tobacco use have become a major concern public health concern across the globe. As such, global public health agencies should focus on strengthening programs aimed at preventing oral diseases and promotion of improved oral health. One of the ways of strengthening preventive programs such as tobacco-use cessation programs include increasing the content of education by introducing a component of oral health risk awareness to improve the perception and attitude towards tobacco-use cessation programs. According to Marlow (2006), studies have shown that effective implementation of cessation programs has contributed significantly towards reduction of adult and youth consumption of tobacco in the United States. Research has shown that the commitment by individuals willing to stop using tobacco is significantly influenced by inadequate awareness and education about the health risks associated with tobacco use as well as poor training (Qidwai, 2004). The content of cessation tobacco cessation programs influence the successful implementation and outcomes of such programs. Most of these programs are focused on initiating behavior change by encouraging tobacco users to quit the habit without emphasizing on the benefits accrued from the behavior change. In addition, lack of awareness about the existence of community based tobacco cessation programs has also significantly undermined participation and outcomes of such programs. Poor perception about the cessation programs has also emerged as a major barrier to the participation in the programs (Bolly, Lovato, & Murphy, 2006). Despite the desire among many smokers to quit the habit, poor perceptions such as the view of the programs as meant for addicts and social misfits continue to discourage many from participating in the programs. According to Martin, Bruskiewitz and Chewning (2010), Tobacco uses must understand the potential oral health risks associated with tobacco use in order to appreciate the importance of quitting the habit. Awareness about such risks serves as a motivational factor towards participation and commitment to adhere to proposed strategies for overcoming the addiction (Bolly, Lovato & Murphy, 2006). Creation of awareness about the tobacco cessation programs and their role in the public health at both individual and community levels provides an opportunity to address misleading perceptions about the programs. The entire community rather than just the target population must understand the reason behind initiation of the programs. In addition, community involvement in the designing and implementation of the program would also ensure that the needs of the community are taken into account to avert resistance and development of poor perceptions about the programs (Pentz,1999). Some of the effective strategies for educating people about the oral health risks associated with tobacco use including the use diagrams to demonstrate how smoking affects the different parts of human body including the teeth, and the different parts of the respiratory system overtime. Educators can also make use of people already affected by conditions associated with the smoking habit to narrate their ordeal and help those will to avoid similar suffering to commit themselves into the cessation program. The cessation program should be made inclusive by incorporating tobacco use prevention initiatives to incorporate other members of the society who have not yet started smoking. The education and training must be undertaken using easy to read and interesting materials to ensure effective understanding as well as encourage positive participation. Practicum Design The project assumed a prospective exploratory design in which the focus was to examine the impact of education and training components in a tobacco cessation program. Precisely, the practicum design applied in the project was an exploratory qualitative research design. Methods Design and Sample I conducted a cross-sectional survey with self-administered questionnaires. A group of individuals willing to quit the use of tobacco was recruited to participate in the project and was first subjected to an evaluation process to determine knowledge gaps about the oral health risks associated with tobacco use as well as their perception about tobacco cessation programs. Such information was obtained using the self-administered questionnaires specifically designed my me to elicit such information. The 95 participants were randomly selected using a sample size table formulae from the large number of volunteers. The participants went through an education and training process aimed at imparting knowledge about the oral health risks associated with tobacco use, strategies for successfully quitting the behavior, the role of such programs in the society and the benefits for participating in the tobacco cessation program. The author of this report designed the education program content as guided by the test questions in the Appendix B to ensure that aspects of oral health are comprehensively captured. The intended knowledge was passed through PowerPoint presentations, videos involving life testimonies of people struggling with disease conditions associated with tobacco use, diagrams on how tobacco chemicals affect may affect the different parts of the oral system, and brief notes. Upon completion of the 4 weeks education and training, the participants were again evaluated using questionnaires and a simple test to establish improvement in knowledge, change in perception and the support for participation in such programs. Implementation of the Practicum Implementation of the proposed education and training took place within the premises of Keller Army Community Hospital with the participants required to attend the program during the weekends. The education and training process involved the use of PowerPoint presentations, printed notes, diagrams, and discussion through an online discussion forum. Diagrams were specifically applied to show how smoking affects the various parts of the body with significant focus on the mouth, and the respiratory system. The institution provided the venue and all the resources required to facilitate implementation of the project in line with its commitment in public health preventive activities. Volunteer staff members from the institution played a critical role in the education and training of the participants. The content of the education program was designed to capture all the important information on the association of tobacco with various oral health conditions and the benefits of participating in the cessation program. Upon completion of the education and training process, all participants were required to do a short examination and later fill a self-administered question to ascertain the impact of the process on various parameters of tobacco-use cessation programs such as perceptions, awareness, and knowledge of health risk factors and the willingness to commit themselves into quitting the unhealthy behavior or habit. Information collected prior to the implementation of the education and training component was used as the benchmark for ascertaining the potential impact of such a step towards improving participation and outcomes in tobacco cessation programs. The scores on the test, evaluated knowledge gained through the education and training process and potential of such knowledge serving a motivational factor among the participants. The identity of the participants was, however kept anonymous throughout the study to avoid any ethical issues that may arise from the handling of the participants’ data. Results Pre and Post Test Score Frequency Table Pretest Scores Post-Test scores Grades Frequency Grades Frequency 50-59 35 50-59 5 60-69 25 60-69 10 70-79 20 70-79 35 80-89 10 80-89 25 90-100 5 90-100 20 Mean Score 48.15% 79.10% Findings Results from the pre- and post-education assessment tests indicated an improvement in the post-test mean of 79.1% compared to the pretest mean score of 48.15%. Answers from the post-education questionnaires showed that about 95% of the participants were positive about participating in the Tobacco cessation programs compared to the 65% recorded in the pre-education questionnaire responses. A results from the survey conducted using specific questions in the questionnaire indicated that 80% of the participants knew the different techniques for overcoming the smoking addiction while 20 % indicated that they were not sure such techniques would help them quit the habit. Discussion Results from the post-education test indicated an improvement from the pretest thus demonstrating that the education program increased the knowledge about oral health risks associated with tobacco use among the volunteering participants in the study. Tobacco users showed the willingness to quit the habit as well as the urge the learn more about the health risks associated with tobacco use. Significant increase in the number of participants desiring to participate in the tobacco cessation programs compared to the questionnaire responses prior to the education program affirmed that incorporation of comprehensive education program into tobacco cessation would be effective in increasing participation and improve on the program outcomes. The high percentage of participants confident about the various techniques for quitting the smoking habit demonstrated that education and training on such techniques could have positive impact on the perception of the cessation programs. Therefore, educating and training individuals willing to quit the use tobacco as one of the preventive measures against oral diseases can play a critical role in addressing barriers such as poor perception, lack of adequate knowledge and lack training which hinder the effective implementation and outcomes of tobacco cessation programs. Limitations in the Study The main limitation in the practicum includes the use a convenience sample, which would likely limit generalization or application of the findings. In addition, the study did not show how the education program would influence the overall outcomes of the cessation programs especially the success in reducing the number of tobacco users. There is need for further studies involving a larger sample of volunteers willing to quit the habit of smoking and subsequent implementation of the cessation program in the same population to determine the influence of the education program outcomes. This would allow generalization of the practicum findings and enable implementation of the suggested changes to enhance the outcomes of tobacco cessation programs. Conclusion The practicum demonstrated that improvement of tobacco cessation programs’ content through incorporation of a comprehensive educational program could improve participation and outcomes of such programs in preventive health. Educating and training individuals willing to quit the use tobacco as one of the preventive measures against oral diseases can play a critical role in addressing barriers such as poor perception, lack of adequate knowledge and lack training which hinder the effective implementation and outcomes of tobacco cessation programs. Creation of awareness about the tobacco cessation programs and their role in the public health at both individual and community levels provides an opportunity to address misleading perceptions about the programs. The entire community rather than just the target population must understand the reason behind initiation of the programs. Much focus in tobacco cessation programs should be channeled towards creation of awareness about health risks associated with tobacco use through education of the public. References Ask. Advise. Refer. Org. (n.d). Tobacco cessation protocols for the dental practice. Ask. Advise. Refer. Org. Retrieved from http://www.askadviserefer.org/downloads/Tobacco_Cessation_Protocols.pdf Bolly, K., Lovato, C., & Murphy, C. (2006). Training in tobacco cessation counseling for medical, nursing, dentistry and pharmacy students: Environmental Scan and Recommendations. The Canadian Public Health Association. Retrieved from http://www.cpha.ca/uploads/progs/substance/tobacco/chpscstudyfinal.pdf CDC. (2013). Smoking cessation. Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/ Hopkins, D et al. (2001). Reviews of evidence regarding intervention to reduce tobacco use and exposure to environmental tobacco smoke. American Journal of Preventive Medicine 20 (2), 16-66. Lee, J et al. (2011). Successful implementation of a wellness and tobacco cessation curriculum in psychosocial rehabilitation clubhouses. BMC Public Health, 11 (1), 702-712. Marlow, L. (2006). Tobacco control programs and tobacco consumption. CATO Journal, 26 (3), 573-591. Martin, B., Bruskiewitz, R., & Chewning, B. (2010). Effects of a tobacco cessation continuing professional education program on pharmacists’ confidence, skills, and practice-change behaviors. Journal of the American Pharmacists Association, 50 (1), 9-16. Mong, C et al. (2011). High prevalence of lung cancer in a surgical cohort of lung cancer patients a decade after smoking cessation. Journal of Cardiothoracic Surgery 6 (19). Retrieved from http://www.cardiothoracicsurgery.org/content/6/1/19 Peiper, N., Stone, R., Van Zyl, R & Rodu, B. (2010). University faculty perception of the health risks related to cigarettes and smokeless tobacco. Drug & Alcohol Review, 29(2), 121- 130. Pentz, A. (1999). Effective preventive programs for tobacco use. Nicotine & Tobacco Research, 1, 99-107. Petersen, E., Bourgeosis, D., Ogawa, H., Estupinan-Day, S & Ndiaye, C. (2005). The global burden of oral disease and risks to oral health. Bulletin of the World Health Organization, 83(9), 661-669. Qidwai, W. (2004). Barriersto smoking cessation: Results of a survey among family practice patients. Middle East Journal of Family Medicine, 5(5), 1-12. Appendix 1 Semi-closed questionnaire QUESTION Answer 1. Does smoking and use of tobacco product affect your oral health Yes No 2. How does use of tobacco affect your teeth? 3. Does use of tobacco through smoking and other forms increase your risk for respiratory disease? If yes, state how?, 4. Does smoking or chewing tobacco products cause dental caries or teeth decay? Yes No 5. What are some of the dental disease associated with tobacco use? 6. Do you believe you can get different type of cancer from using tobacco? Yes No 7. Can smoking and other forms of tobacco result into death? Yes No 8. Have you heard of tobacco cessation programs in your area? Yes No 9. Do you think enrolling for tobacco cessation programs can help you stop using tobacco products especially smoking cigarettes? Yes No 10. Would you participate in a tobacco-cessation program? Yes No Appendix Test questions 1. State three possible effects of tobacco use on your oral health 2. Which parts of the body may be affected by tobacco use? 3. Explain how tobacco can lead to oral health conditions such as dental caries and periodontal disease. 4. Are there less harmful tobacco products? if any list them. 5. Can one successfully stop using tobacco products including cigarette smoking? 6. What is a tobacco-cessation program? 7. What are the benefits for participating in such as a program? 8. What are some of the techniques for stopping tobacco or cigarette smoking? 9. Can non-smokers living amongst smokers be affected in the same way as those directly involved in the habit? 10. Why should you consider participating in tobacco-cessation programs? Read More