presented by James Carlson
Smoking and smoking-related illness remains a costly burden to society and the health care system in the United States. Rates of tobacco use dropped considerably between 1965 to 2000; the decline has slowed since. Despite the majority of smokers' willingness to make a quit attempt during an office visit, most clinicians do little more than ask about tobacco use. The breadth of our scope of practice and frequency of patient contact provides a great opportunity for physical therapists to engage in addressing this public health problem. This course aims to provide the therapist with an understanding of the effects of tobacco use on body systems, its impact on health care outcomes, the benefits of cessation, and a framework to address cessation in clinical practice. By engaging in tobacco cessation, therapists can positively influence the chances of success while enhancing patient/client relationships.
Mr. Carlson received a Bachelor of Science degree in Exercise Physiology (1996) and his Masters in Physical Therapy (1999) from the University of Wisconsin-Madison. He has delivered numerous CE courses on rehabilitating cardiopulmonary patients for the WPTA and University of Wisconsin – Milwaukee. In 2015, he provided a course entitled Cardiopulmonary Essentials: Applications to Clinical Practice for the Army-Baylor DPT program as part of the Distinguished Lecture Series. He has been an Honorary Associate/Fellow for the University of Wisconsin – Madison since 2009, where he has been the lead instructor for The Cardiovascular and Pulmonary Aspects of PT course. He received his Cardiopulmonary Clinical Specialist Certification through the APTA in 2012. He developed the curriculum and serves as the lead mentor for the William S. Middleton VA’s Cardiopulmonary Physical Therapy Residency program. He has been the Lead PT for the William S. Middleton VA Hospital’s Heart and Lung Transplant program as well as serving as the lead primary clinician for the William S. Middleton VA’s Cardiopulmonary Specialty Clinic for the past 17 years.
The focus of this chapter is to highlight disparities in addressing tobacco cessation. Specific patient populations have higher rates of tobacco use, fewer quit attempts, and lower rates of successful cessation. By recognizing at-risk populations, the clinician will identify more opportunities to engage in addressing tobacco use status and cessation during clinical interaction.
Personalizing education regarding tobacco use improves the chances of successful cessation. This chapter will highlight the negative effects of tobacco use and describe the benefits of cessation on health, mortality, and patient outcomes. Understanding tobacco’s impact on body systems will improve the ability to personalize clinician advice.
This chapter will introduce the clinician to the “5 As” approach for addressing tobacco use and cessation: Ask, Advise, Assess, Assist, and Arrange. Using the 5 A’s framework will help the clinician apply a proven methodology for addressing cessation. Patient simulation will be utilized to model aspects of the 5 A’s into clinical care.
Understanding barriers to quitting and preventing relapse is an important aspect of supporting tobacco cessation. This chapter will describe common roadblocks and barriers, physiological and psychological effects of withdrawal, and provide an approach to predicting and preventing relapse. Patient simulation will be utilized to model ways to discuss barriers, withdrawal, and relapse, empowering the clinician to address these difficult aspects of tobacco cessation.
This is a question and answer session with Ellen, a first year physical therapy student, about the topic of tobacco use and her school curriculum.