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Smoking Cessation Education in the Elderly

by Jennifer Gerhardt, Student Nurse
Tammy L. Stuart MS, RN
Massachusetts College of Pharmacy and Health Sciences

 
Introduction

Cigarette smoking rates continue to be on the rise despite the overwhelming health consequences. According to the U.S. Department of Health and Human Services “Smoking is the most preventable cause of death and disease in the United States” (Healthfinder.gov, 2009). Statistics indicate that approximately 500,000 people die each year from smoking cigarettes (CDC, 2007). Evidence shows that there are a little more than 45 million adults living in the U.S. and about 21% of them smoke cigarettes, and almost 10% are 65 years or older (CDC, 2007). The role of the professional nurse as direct care provider and educator is pivotal in providing clients with the information and support necessary to facilitate smoking cessation and improve client health outcomes.

Smoking cigarettes is a major health disparity in the United States. The CDC reports that smoking and it’s influence on disease has contributed to a rise in healthcare costs which totals a little over 90 million per year (CDC 2007). Smoking contributes too many chronic diseases such as emphysema and chronic bronchitis (COPD). Lung cancer is part of a group of smoking-related diseases that leads to “the largest number of smoking-related deaths” (CDC 2006). Smoking is a risk factor for many other chronic diseases such as coronary artery disease, atherosclerosis, stroke, heart disease, diabetes, hypertension and cancer. The elderly is the fastest growing population and about 75% of deaths in this population are caused by chronic illnesses such as cancer and heart disease which can be linked to cigarette smoking (CDC, 2006, 2007, 2008).

Smoking cessation has been proven to show immediate health benefits to the individual. In 2004 according to the Surgeon General about 20 minutes after the smoker quits their heart rate drops, 12 hours after quitting the levels of carbon monoxide decreases to normal levels and two weeks to three months after quitting the risk for a heart attack decreases and lung function improves (The 2004 Surgeon General's Report: The Health Consequences of Smoking, 2004) Professional nurses need to facilitate health promotion education specifically, smoking cessation with their elderly patients due to the direct link with improved health outcomes.

Nurses are among the largest population of healthcare workers with direct patient care responsibilities and as a result are on the front lines of the war on smoking. Nurses educate patients on a multitude of information which may include medications, invasive and interventional procedures, medical conditions, lifestyle changes, disease prevention and health promotion. Nurses’ have the ability; with their knowledge of disease and their role as direct care providers to provide education and interventions that facilitate smoking cessation (Cataldo, 2007; Roberts, 2002; Trossman, 2005, Healthfinder.gov, 2009).

Literature Review

There are many advances in medical and nursing research related to cigarette use and its impact on disease prevention and health promotion. Common interventions include pharmacological therapies such as nicotine replacement therapy (nicotine patches, gum, lozenges, sprays, and inhalers) and anti-depressant therapy, which if used correctly have been shown to have successful outcomes. Non-pharmacological therapies include practices such as hypnosis, acupuncture, herbal supplements, and support groups such as Nicotine Anonymous. There is little research on the best method for ensuring success with smoking cessation in the elderly, particularly with evidence-based nursing interventions (US Department of Health and Human Services; Public Health Services, 2008).

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