Panhandle Kicks the Habit Smoking cessation project from Department of Medicine and Pharmacy TTUHSC

Rahul Chandra MDAssistant ProfessorDept of Medicine ,TTUHSC Amarillo

Cigarette Smoking

Cigarette smoking is injurious to health everybody knows that !!!!!!!

Its says on the cigarette pack !

Our logo

Spread the word ……….

ObjectivesObjectives:To compare percent of enrolled subjects who achieve abstinence

from smoking at 8 weeks and 6 months compared to Cochrane database.

To compare percent of subjects who attempt to stop smoking by enrolling in the study to average percent of other studies.

To compare subjects who use the Facebook page; text messaging support; smartphone application or combination of these as offered by the program cessation rate to subjects who do not utilize the program.

To compare subjects, who do not completely quit smoking, amount of cigarettes per week at baseline to end of study.

Validate self-reports of abstinence between baseline and 8 weeks by measuring a level of exhaled carbon monoxide ≤10 ppm.

Inclusion Criteria Current SmokerAge 18-100Admitted to Northwest Texas Hospital under

Texas Tech Internal Medicine serviceWilling to try to quit smokingAdmitting diagnosis of one of the following:

Chronic Obstructive Pulmonary Disease, Hypertension, Asthma, Chronic Heart Failure, Diabetes Mellitus, History of Coronary Artery Disease or Cerebrovascular Disease, Pneumonia, or Peripheral Vascular Disease

Exclusion CriteriaComatoseIntubated Hospice PregnantBreast feedingPsychosisDoes not understand English or Spanish

Precautions for NRT Active Unstable anginaActive MI Arrhythmias HyperthyroidismPheochromocytoma Accelerated hypertensionAcute StrokeAllergy to nicotineAllergy to tape

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PANHANDLE KICKS the HABIT

Recruitment The Northwest smoking cessation educator will identify smokers who are on Texas Tech Internal Medicine services. She will provide a brochure about the study and explain the purpose. If a patient is interested she will use a Screener form to ensure that the patient is a candidate for the study looking at basic inclusion & exclusion criteria.

Initial Intervention

IN HOSPITAL INTERVENTION PRIOR TO DISCHARGE By the Northwest Smoking Cessation Educator

1) Counseling 2) Medications* (patch, gum or combination) 3) Introduce Social media how to access

“Facebook” , text messages, and phone application.

4) Survival kit( Information card, stress ball, candy, mints and paper clips)

5) Free 30 day membership to gym may be offered

Inclusion Criteria: Current Smoker Age 18-100 Admitted to Northwest Texas Hospital under Texas

Tech Internal Medicine service Willing to try to quit smoking Admitting diagnosis of one of the following:

Chronic Obstructive Pulmonary Disease, Hypertension, Asthma, Chronic Heart Failure, Diabetes Mellitus Type 2, History of Coronary Artery Disease or Cerebrovascular Disease, Pneumonia, or Peripheral Vascular Disease

Exclusion Criteria: Comatose Intubated Hospice Pregnant Breast feeding Psychosis Does not understand English or

Spanish

Obtain consent for intervention (which means Inpatient counseling, drug therapy, follow-up counseling and social media/phone supplement (Facebook, text messages & phone app)

Agree for intervention Disagree for intervention

Continue to enroll subject in study: 1. Fill out Initial Questionnaire 2. FTND Questionnaire 3. Why do you Smoke Questions 4. Baseline Carbon Monoxide Level

OutcomesPrimary outcomes:

Eight weeks of smoking cessation, defined as self-reported abstinence for 8 weeks (assessing every 2 weeks) and validated by measuring a level of exhaled carbon monoxide of < 10 ppm22.

The percent of subjects who attempt to stop smoking by enrolling in the study compared to Cochrane database review of 2008. 23

Secondary outcomes include:Subjects who use the Facebook page; text messaging support; phone application or combination of these as well as their abstinence rates defined as self-reported at 8 weeks and validated by measuring a level of carbon monoxide compared to subjects who did not use these resources.

The percent decrease of cigarettes/week if subject is still smoking at end of study.

Abstinence rate at 6 months by a telephone call by subjects self-reporting.

Intervention at Follow-up

oCarbon Monoxide testing at each follow-up visit

oGroup Education at least 30 minutes per session but not more than 60 minutes.

oRefill Medications (patch, gum, or combination)

oFollow-up kit sunflower seeds, hard candy, gum and/or toothpicks. oFollow-up questionnaire (Appendix E) pertains to questions about

oquitting success

ofeedback on NRT

oactual use of and feedback on Social media forms of Facebook , text messaging, & phone app

odocuments any readmission to hospital

Follow-up Interventions

Every 2 weeks till a total 8 weeks (60 days) Up to 12 weeks if patient wants

Smartphone application

Text messaging 1. Open Internet Browser

2. Enter: smokefree.gov (see below)

3. Click on SmokefreeTXT (see above)