Smoking Cessation Treatment: The System-Level Intervention

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  1. System-Level Intervention
  2. Design of the System-Level Intervention
  3. Participants
  4. Organizational Change Strategies
  5. Implementation
  6. Therapy and Treatment for People’s Nicotine Dependence
  7. References

Smoking was discovered as public health issue nearly a century ago. In the 1930s, health care practitioners began to understand the dangers caused by the use of tobacco entirely. Today, tobacco is the leading cause of many preventable diseases, disabilities, and several deaths in the United States. For example, about 34 million US adults smoke cigarettes, while over 16 million Americans live with at least one illness caused by smoking (Centre for Disease Control and Prevention, 2021b). Additionally, close to 1,600 youths under 18 try their first cigarette, and out of this approximately 235 of them end up smoking. There are systems gaps due to either weak policies or practices designed by health institutions (Tan et al., 2022). This paper, therefore, discusses the system-level interventions, goals, participants involved, the organizational change strategies, implementations, and the expected outcome.

System-Level Intervention

The systematic incorporation of evidence-based tobacco treatment that includes cessation is not yet seen as standard care. However, smoking cessation is a powerful and cost-effective intervention that should be availed all clinical settings (Pipe et al., 2022). Individuals may opt for different methods either through medical professionals or unassisted processes. For example, Cold turkey which is an abrupt withdrawal technique has been the most successful method for about 88% of those who quit. There is the medication-based method where drugs are used to help addicts stop. The community procedure normally involves talking, educating, and counseling victims to desist from smoking. Additionally, gradual reduction involves assisting the patients to lower their daily intake of nicotine. Lastly, financial incentive scheme uses money benefits to lure, motivate, and encourage smokers to quit.

Goals

Tobacco dependence is a chronic and degenerating condition catalyzed by addiction to nicotine. However, cessation treatment can help individuals, or groups quit smoking. The goals are to reduce the risk of premature death, improve health, and enhance the quality of life among people (Centers for Disease Control and Prevention, 2020a). It is meant to suppress the risk of many adverse health effects, such as poor reproductive health outcomes, cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and cancer. Thirdly, to improve the health of pregnant women and of their unborn babies (Centers for Disease Control and Prevention, 2020a). Fourthly, to enhance the treatment conditions of people already diagnosed with coronary heart disease so that their situations may not worsen. Additionally, to eliminate the financial burden that smoking places on people who smoke, healthcare systems, and society in general.

Design of the System-Level Intervention

A systems-level approach to smoking cessation treatment requires healthcare providers to adhere to guidelines, procedures, and action plans. Further, all interventions must be modified to target the patients’ risk behaviors relating to their smoking tendencies through clear communication strategies. They should be designed to include self-help that incorporates educating the patients to make a personal decision, the steps to successfully quit, setting a specific quit date, and using substitutes for smoking. A brief advice (BA) for consulting and providing information to the patients on the potentially harmful effects of smoking, how to quit, and where to look for help (Odorico et al., 2019). Additionally, there must be a multiple sessions of behavioral change strategies, and community-based interventions. Lastly, community-based intervention should involve public campaigns through various forums.

Explanation of How the System-Level Intervention Addresses a Public Health Issue

Health systems can adopt policies and changes to integrate tobacco-dependence treatment into routine care to ease the delivery treatment procedures. The intervention and its action plans that include health warnings could reduce smoking greatly (Levy et al., 2018). It will protect nonsmokers from the effects of secondhand smoke, increase withdrawal among cigarette users, and prevent those who do not smoke from picking up the habit from those who are already addicted. Further, it will reduce smoking initiation in children and teens, and decrease the rates of non-communicable diseases among many people. In addition, health workers could successfully implement cessation in areas where access to care is difficult such as low-income communities, when the availability of medics is limited (Odorico et al., 2019). Likewise, the system could strengthen society’s approach to community-based smoking cessation programs.

Participants

Tobacco cessation interventions should be focused on populations that are more likely to smoke and currently heavier smokers. Pregnant women are a priority because of the health risks posed to their unborn babies. Secondly, cigarette smoking is normally high among the lesbian, gay, bisexual, and transgender groups, making them a target for this intervention. Adults with chronic non-communicable diseases, and co-occurring substance use disorders are heavy smokers and are targets too (US Department of Health and Human Services, 2020). In addition, adolescents aged between 18 and 26 years try smoking for the first time due to peer influence or they see it as rebelling and showing independence. Key stakeholders to implement the intervention should include government agencies, medics, clinicians, medical researchers, and both public and private health organizations because they are directly involved in formulation healthcare policies.

Organizational Change Strategies

Description Goals Strengths Weaknesses
Nicotine patch replacement therapies Meant to help the patient emancipate nicotine and provide them with a constant lower level of the substance throughout the day The goal of the therapy is to reduce on cravings for nicotine and ease the signs of the substance withdrawal The medication eases nicotine withdrawal signs, giving enough relief to enable the smoker to focus on learning new ways of thinking and behaving without tobacco The main limitation of this therapy is its side effects such as skin irritation and vivid dreams that need the patch to be removed before the patient goes to bed
Behavioral and psychological treatment It includes cognitive therapies like learning cognitive, coping skills, negative mood or urge to smoke that is linked with serious nicotine abolition It seeks to assist the patients by conveying the historical learning processes directly relevant to smoking and the factors that make it hard for addicts to stop smoking – It enables addicts to manage cravings and withdrawal signs
– Helps those affected to know why they smoke and how to avoid replaces		 – It could have effect on those with complex mental problems because it requires structured sessions
– Because it involves confronting emotions and anxieties, some people may be anxious and emotionally uncomfortable

Explanation of How Each Strategy Addresses a Public Health Issue and Expected Outcomes

Explanation of How each Strategy Addresses a public health issue Expected Outcomes
Nicotine patch replacement therapies The therapy is a treatment that assists those who are addicted to smoking to stop the behavior. It is made with products that supply those affected with low doses of nicotine but not having many toxins that are found in cigarettes (UCSF Health, n.d.). After its application, nicotine levels are elevated one to two hours to reduce intense craving from highly dependent smokers. Relief of physical withdrawal signs and allowing addicts to focus on the emotional aspects of quitting
Behavioral and psychological treatment It focuses on identifying and changing maladaptive thoughts, emotions, and behaviors that trigger, worsen, and maintain an array of issues including depression, anxiety, and addiction (Harte, n.d.). It involves making smokers aware of their habits, Then assisting the addicts to set their quitting dates, before finally quitting and maintaining the trend without returning to smoking Patients quitting the smoking habit through change of attitude and behavior

Implementation

Nicotine Patch Replacement therapy

Physicians, dentists, and other health professionals can provide necessary assistance to their patients who smoke. Further, Clinicians must give nicotine replacement items such as nicotine gum or transdermal patches daily. In addition, a single patch is worn each day and is replaced after 24 hours. The Medics should always patch different areas above the waist or below the neck every day (MedlinePlus, n.d.). They should be put on hairless spots and those who wear them for 24 hours normally have fewer withdrawal symptoms. Additionally, in case wearing them at night causes you some odd dreams, just do the usual sleep without the patches. However, patients must not smoke while using nicotine replacement because it could make the substance build up to toxic levels, thus, the dosage of nicotine should be reduced slowly

Behavioral and Psychological Treatment

Smoking cessation interventions are usually driven by theories of behavior change. Therefore, the interventions should be in the form of advice, discussion, encouragement, counseling, and other activities that are designed to assist those addicted to successfully quit (US Department of Health and Human Services, 2020). Behavioral and Psychological Treatment should involve three phases of preparation to enhance the victims’ motivation to quit and build their confidence. The intervention must include support, copying, substitute behaviors, and counseling. The behavioral therapists must optimize self-regulatory abilities and skills of the patients to give them social support. The delivery must be through brief advice on smoking cessation from a health care professional. Counselors should schedule face-to-face appointments with smokers either on daily or weekly basis. Lastly, there must be self-help materials delivered to them on leaflets, audio recordings, videos/DVDs, and Internet-based materials.

Therapy and Treatment for People’s Nicotine Dependence

Nicotine Patch Replacement Therapy

People who are addicted to nicotine should use its replacement or drug therapy to help them quit. Signs of severe nicotine dependence are smoking more than one packet per day, taking cigarettes within 5 minutes after waking up, or while sick, or easing symptoms of withdrawal. Nicotine replacement used to be used by all participants who are heavily addicted and want to quit smoking except pregnant women and adolescents (American Cancer Society, 2022). Additionally, those who are still smoking or using other forms of tobacco must not use nicotine patch replacement. However, stakeholders such as medics, health organizations, and government agencies dealing with medical issues must be consulted for professional advice before medication therapy is administered.

Behavioral and Psychological Treatment

Quitting smoking and overcoming nicotine dependence requires a multi-faceted approach that may include counselors, support groups, behavioral therapists, clinicians, nurses, and specialized doctors for medical diagnosis and prescriptions. Participants may include pregnant women due to health risks posed to the unborn babies (UCSF Health, n.d.). Lesbians, gays, bisexuals, and transgender groups are important groups due to their frequent tendencies of smoking. Additionally, adults with chronic non-communicable diseases because they are already addicted to smoking cigarettes. Lastly, adolescents because they like trying smoking for the first time dues to peer pressure.

References

American Cancer Society. (2022). . Web.

Centers for Disease Control and Prevention. (2020a). . Web.

Centre for Disease Control and Prevention. (2021b). . Web.

Levy, D. T., Jamie, T., Kuo, C., Fong, G. T., and Chaloupka, F. (2018). . Journal of Public Health Management and Practice, 24 (5), 448-457. Web.

MedlinePlus. (n.d.). Nicotine replacement therapy. National Library of Medicine. Web.

Odorico, M., Le Goff, D., Aerts, N., Bastiaens, H., and Le Reste, J. Y. (2019). . Vascular Health and Risk Management, 15, 485-502. Web.

Pipe, A. L., Evans, W., and Papadakis, S. (2022). . BMJ Journals, 31 (2). Web.

Tan, M. M., Wilkins, A. V., Styrczula, P., and McBrayer, S. (2022). . National Library of Medicine, 29. Web.

UCSF Health. (n.d.). . Web.

US Department of Health and Human Services. (2020). Interventions for smoking cessation and treatments for nicotine dependence. National Library of Medicine. Web.

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