Smoking Cessation Interventions Psychosocial and Pharmacological Interventions Essay

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Smoking Cessation Interventions

Psychosocial and Pharmacological Interventions on Smoking

Of the many causes of death in the world, coronary heart disease (CHD) remains one of the top global killers with an estimated 7.2 million people dying each year (Howell, 2011). The United States comprises a great majority of this mortality rate, which is approximately 450, 000 deaths in the United States alone (Capewell, et.al, 2010). Fortunately, since the 1970s CHD mortality rates in most industrialized nations have been reduced, especially in the younger populations (Capwell, et.al, 2010). A large majority of the American population, however, remains at heightened risk for developing cardiovascular disease, largely due to elevated cholesterol levels, even after smoking cessation. (Capwell, et.al, 2010). These increased cholesterol levels can result in hypertension, hypertriglyceridemia, and eventual development of atherosclerosis (Bass, 1991).

CHD is even more problematical in individuals that smoke. Over time smoking causes diseased arterial smooth muscle and, thus, is a clear risk factor for coronary heart disease (Bass, 1991). A clear solution, which is not so simple in practice, is that stopping smoking lowers risk. Mortality risk can be reduced by as much as 36% when smokers with CHD decide to quit smoking compared to those who continue to smoke (Critchley, 2003). In fact, drastic decreases in myocardial infarctions have been demonstrated when smokers stop smoking for as little as one year (Quist-Paulsen, & Gallefoss, 2003). Unfortunately, as most doctors and nurses can attest, many patients diagnosed with CHD continue to smoke despite the availability of smoking cessation interventions, medications, and programs.

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Purpose Statement

In my own practice I have observed patients come into the hospital repeatedly, continuing to smoke, despite their diagnosis of coronary heart disease. This has spurred my interest I in finding successful measures to encourage smoking cessation in patients who have coronary heart disease. The purpose of this synthesis of the literature is to answer my PICO question: In patients with CHD who smoke how do psychosocial interventions compare to pharmacological interventions as related to smoking cessation?

The nurse can play a very important role in promoting smoking cessation. After reviewing much of this research I believe the information will be useful for communicating the importance of smoking cessation to my patients. Prior to starting my research I would merely give my patients the usual and basic information regarding the health effect of smoking. It did not seem, however, that I was effectively communicating the gravity of the health effects. As a result, I've found the topic of smoking cessation very interesting, and I am committed to learning new and effective ways of communicating the importance of smoking cessation to my patients. I enjoy talking with patients about the supportive resources at their disposal and, as a nurse practitioner; I can eventually help with pharmacologic interventions by prescribing nicotine replacement therapy.

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