Running Head: SMOKING CESSATION

Smoking Cessation
 Running Head: SMOKING CESSATION

1.0 Introduction

Cigarette smoking or rather tobacco is the leading cause of disease that can be prevented.

Assisting individuals with smoking cessation is a vital assignment for health professionals and

the significance of stopping smoking behaviors is well known. Smoking is regarded as a global

epidemic and a vital health problem (García-Gómez et al., 2019). It is associated with premature

deaths due to increased risks of developing health problems including lung diseases, stroke,

cancer, and chronic obstructive pulmonary disease (COPD) (García-Gómez et al., 2019).

Smoking cessation interventions are an urgent issue due to the increased use of tobacco and

related health conditions. Smoking cessation involves the following readiness state not ready

(pre-contemplation), unsure (contemplation), ready (preparation), action, and maintenance

(Kumar & Prasad, 2014).

1.1 Case

Jane 47-year-old nurse assigned to a hospital psychiatric department has been smoking for the

past 10 years. She developed a smoking routine while at work which involved smoking 6 times a

day in the smoking shelter with other nurses. She has been bordered by cessation of smoking for

quite some time because of her role in promoting health and role model as a nurse. She has been

experiencing breath shortness, tobacco stains, and a smoker’s voice cough and therefore plans to

quit smoking with the help of services provided aimed at smoking cessation in the health setting.

1.2 Plan

For effective smoking cessation by jane, the plan involves the use of motivational

interviewing to enable her to change her smoking behavior. Motivational interviewing refers to
 Running Head: SMOKING CESSATION

counseling intervention used in helping individuals to increase their chances of changing

behaviors that they are addicted to (Widder, 2017). Motivational interviewing will enable the

exploration of the client and resolve her smoking behavior. The technique employs the following

principles expression of empathy, developing discrepancy, rolling with resistance, and support

self-efficacy (Widder, 2017). The motivational interview will enable one to comprehend the

ambivalent feelings of the client, and the difficulties associated with quitting smoking and

outline the merits of smoking cessation with the client. It will involve the use of open-ended

questions for easy understanding of the client position on the behavior change and enhance

communication flow. The smoking cessation plan using motivational interviewing will be guided

by the Transtheoretical model’s five stages.

1.2.1The transtheoretical model

The transtheoretical model is a behavior change model that is employed in assessing an

individual’s readiness of embracing new health behavior and providing strategies and change

processes in guiding the client. According to the model, behavior change involves six change

stages including pre-contemplation, contemplation, preparation, action, maintenance, and

termination (Lazaro et al., 2019; Prochaska & Velicer, 1997). The five stages of the

transtheoretical model for change readiness can be applied in changing the smoking behaviors of

smoker

Precontemplation stage; the client will be encouraged in during this stage to think about her

smoking behavior and help her in considering smoking as a health problem that requires

immediate attention. Contemplation stage; after the client had agreed that smoking behavior is
 Running Head: SMOKING CESSATION

a problem and she willing to quit, interventions are provided including providing more education

on the consequences of smoking and encouraging the client to focus on positive components of

smoking cessation such as financial stability and better health. The preparation stage; involves

identifying appropriate therapy for smoking cessation, establishing an appropriate date for

quitting smoking, and identifying necessary support. Action and maintenance stages; the action

begins at the determined date of quitting smoking, and it involves providing behavior support

through monitoring of the client via clinical visits and phone calls. Maintenance involves the

client remaining focused and not included in the reuptake of tobacco use and continued

reinforcement to stick to the new health behavior.

Figure 1. The transtheoretical model

1.3 Objective

To describe smoking effects on individual health, risk factors to pregnant women, availability

of smoking cessation measures, and outlining the available options of assisting clients towards

smoking cessation.

1.4 Implementation

Implementing smoking cessation involves the use of the following interventions and

measures; Behavioral measures, Pharmacotherapy interventions including (Buproprion SR,

Varenicline, and Nicotine Replacement Therapy (NRT).

1.5.1 Pharmacotherapy interventions

 Nicotine Replacement Therapy (NRT):

The therapy is used in replacing nicotine from tobacco to help reduction of tobacco use

motivations and the symptoms of nicotine withdrawal. This eases the cessation of the smoking

transition. Nicotine functions through the stimulation of the neural nicotinic acetylcholine

receptors (NAChRs) in the ventral tegmental brain area and leads to dopamine release in the

nucleus accumbens, this leads to reduced levels of withdrawal symptoms of nicotine in

individuals who are on cessation (Wadgave & Nagesh, 2016).

 Buproprion SR

Approved by the U.S. Food and Drug Administration (FDA), Bupropion is used as an

antidepressant for depression symptoms treatments. It has a unique action mechanism among
 Running Head: SMOKING CESSATION

antidepressants because of the reuptake of norepinephrine and dopamine. The medication is

approved for smoking cessation treatment. Tobacco use causes the absorption of nicotine into the

bloodstream and to the brain and results in the release of dopamine into o the synaptic cleft of the

dopaminergic, pleasure-seeking pathways in the brain. The bupropion effect is realized through

its ability to inhibit dopamine uptake by influencing the transport system of dopamine.

 Varenicline

Varenicline is pharmacotherapy for smoking cessation and an effective measure used for

individuals who are willing to quit smoking but not immediately (Ebbert et al., 2015) it is a

selective alpha4-beta2 neuronal nicotinic acetylcholine receptor partial agonist for smoking

cessation therapy. This therapy is regarded as more efficacious compared to bupropion during

smoking cessation. The use of varenicline in the first 24 weeks of smoking cessation leads to a

reduction in relapse and improves the outcomes of the smoking cessation. Despite its benefits,

the FDA revealed the side effects of both varenicline and bupropion, the two pharmacological

therapies are linked to neuropsychiatric adverse effects including behavior change such as

agitation, hostility, depression moods, and suicidal thoughts.

1.5.2 Behavioral measures

Behavioral measures used for smoking cessation include providing advice for smoking

cessation and providing information on quitting smoking. The interventions involve advice from

health professionals, printed information provided to the client, and intense counseling therapies.

Behavioral measures are effective by prompting the client to make attempts of quitting smoking

and maintaining the abstinence behavior in the individual. Behavioral therapy provides
 Running Head: SMOKING CESSATION

information related to the long-term effects of smoking, the financial burdens of smoking, and

the benefits of smoking cessation.

 Behavioral and Pharmacotherapy

Behavioral and pharmacotherapy are combined to increase the rates of smoking cessation.

This involves the use of behavioral elements including counseling cessations combined with

Nicotine Replacement Therapy. Combining behavioral and pharmacotherapy interventions

increases the rates of smoking cessation compared to using a single intervention (Stead et al.,

2016). (Sweet et al., 2019) stresses the need for individuals characterized as active smokers and

willing to quit smoking to undergo counseling sessions for almost four sessions. Behavioral

interventions can be designed by health professionals such as nurses, doctors, social workers, and

counselors. Counseling can also be conducted through mobile devices and should be provided at

a frequency of three times a day to remind the client to stick to the cessation program. The

behavioral intervention at the home ground could use printed information given to the client to

remind him of the consequences of smoking and the benefits of smoking cessation both in short

term and long term.

1.6 Evaluation

The evaluation of smoking cessation will determine the impact of the program and project

outcomes. The results of the evaluation show the effectiveness of the smoking cessation program

on the client. Evaluation helps to determine and track the outcomes and establish how the

objective will be achieved. The evaluation will determine to answer the following questions;

what smoking cessation interventions are used? what are the challenges of implementing the
 Running Head: SMOKING CESSATION

cessation program? what are the factors that have influenced smoking cessation? And how did

the client perceive the smoking cessation program?

1.7 Outcome

Outcomes measures of smoking cessation depend on the interventions used for the client to

change the behavior and quit smoking. The outcomes of the smoking cessation program will be

based on the client’s changes in tobacco use, and whether are there any changes in the

knowledge concerning the consequences of tobacco use. The outcomes also determine the cost-

effectiveness of the interventions used and determine if the intervention utilized saves the

financial status of the client. The outcomes of the program can be considered beneficial if the

client has changed the health behavior over the given period or is still maintaining cessation

habits towards achieving quitting smoking. The outcomes measure also involves client

awareness of smoking and health-related topics including lung cancer, stroke, and hypertension.

1.8 Conclusion

Tobacco use is considered the main cause of health problems globally and is associated with

more than 8 million deaths annually in the world. The deaths are a result of illnesses linked to

smoking including respiratory diseases, cardiovascular and various cancer types (World Health,

2021). With known and proven consequences of tobacco use, the majority of individuals globally

are still smoking mostly in middle- and low-income nations. Tobacco contains nicotine which is

the main ingredient associated with smoking dependence and leads to relapse disorder with

biological mechanisms such as psychological dysregulation. There are various interventions for

smoking cessation including therapeutic interventions for the dependence on nicotine

(varenicline, Nicotine Replacement Therapy, and bupropion,), Behavioral intervention,

combined behavioral and pharmacological therapy, and the use of Electronic Cigarettes for

Smoking Cessation.

Health professionals should make efforts in helping individuals to quit smoking. smoking

cigarettes on daily basis increases the chances of individuals developing various health

complications and this can be prevented with the use of smoking cessation programs with

appropriate interventions applied. The benefits of smoking cessation are gradual and may be seen

from the day, weeks, and over time as the behavior is instilled in a smoker. The benefits of

smoking cessation include low blood pressure, decreased phlegm production and coughs, and

increased lung capacity. Smoking cessation reduces individuals’ risk of developing cancer, and

other chronic illnesses related to smoking tobacco.

1
0

References

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