Medicine and Health Sciences Commons^™

Smoking And Breast Cancer: Girls’ And Boys’ Reactions To Tailored, Internet Delivered Messages, Joan L. Bottorff, Chris G. Richardson, Rebecca Haines-Saah, John Oliff, Peter Hutchinson, Pamela A. Ratner, Chizimuzo T.C. Okoli, Carolyn Gotay, Kenneth Johnson

Nursing Presentations

Background

• Active smoking and exposure to secondhand smoke (SHS) are causally linked to premenopausal breast cancer (BC).

• To date, there have been few efforts to raise awareness of active smoking and SHS as risk factors for BC.

Purpose

• To develop and evaluate messages for Aboriginal and non-Aboriginal adolescent girls and boys to raise awareness about tobacco exposure as a risk factor for BC.

Outcomes Of An Intensive Smoking Cessation Program For Individuals With Substance Use Disorders, Milan Khara, Lindsay Killam, Chizimuzo T.C. Okoli

Nursing Presentations

BACKGROUND: Individuals with substance use disorders (SUD) are disproportionately affected by tobacco use morbidity and mortality. Yet, with adequate intervention, such individuals can be successful in their smoking cessation efforts. The Tobacco Dependence Clinic (TDC) provides tobacco dependence treatment using combined behavioural counseling and pharmacotherapy for clients through the Mental Health and Addiction Services of the Vancouver Coastal Health Authority, British Columbia, Canada.

OBJECTIVES: To a) provide smoking cessation outcomes of participants accessing the TDC b) examine predictors of program completion and smoking cessation of participants of the TDC.

METHODS: Participants of the TDC receive a structured 8 week group …

Tobacco Use Dependence And Approaches To Treatment, Audrey Darville, Chizimuzo T.C. Okoli

Nursing Presentations

Counseling Demonstrates a Dose-Response Effect/Comes in Many Forms

• Brief advice during a “window of opportunity” can increase quit attempts by 40%

• Medication combined with counseling doubles the success rate

• Quitlines: proactive fax to quitline most effective

• Online (becomeanex.org, smokefree.gov, mylastdip.com)

• Cooper Clayton Classes at many local health departments; schedules and provision of medication varies

• I-Phone apps/text to quit

Tailoring NRT to the tobacco user

• Studies show efficacy in smokers and smokeless tobacco users (Ebbert, et al, 2010)

• Combining patch with shorter acting form of NRT has been shown to be safe and effective (Stead, et al, Cochrane Review, 2008; Kozlowski, …

An Evidence-Based Approach To Address Tobacco Dependence Treatment In Mental Health And Addictions Settings, Chizimuzo T.C. Okoli

Nursing Presentations

Purpose: To examine the program completion and smoking cessation outcomes of a tobacco dependence treatment program for individuals with a history of substance use (SUD) and/or psychiatric disorders (PD). Despite the steady decline in the overall smoking prevalence in North America during the last decade some subsets of the population continue to smoke at high rates, particularly individuals with a SUD and/or PD. Among clinical samples, an estimated 75% of individuals with SUD and up to 90% of individuals with PD concurrently smoke. Such findings have prompted the need for tailored tobacco dependence treatment approaches in this population.

Methods: The …

Effects Of A Smoke-Free Law In Parks And Beaches On Smoking Behaviour: Methods To Determine Effectiveness, Chizimuzo T.C. Okoli, Andrew Johnson, Amanda Fallin, Ann Pederson, Anna Liwander

Nursing Presentations

As part of a comprehensive approach to tobacco control,smoke free laws have resulted in reductions of indoor air pollution, improvements in respiratory and cardiovascular health, reduction of smoking uptake by youth, and increasing tobacco use cessation in various jurisdictions. Although many studies have demonstrated the beneficial effects of smoke-free policies in indoor spaces (e.g., restaurants, bars, workplaces, hospital settings, etc.), little is known about the effectiveness of such policies in outdoor public spaces. On September 1st, 2010, Vancouver’s smoke-free by-law for the city’s parks, beaches, and facilities came into effect. The aims of this study are two-fold: a) to examine …

Smoking On The Margins? Assessing The Health Equity Effects Of A Smoke-Free Law In Parks And Beaches, Chizimuzo T.C. Okoli, Ann Pederson, Steve Chasey, Wendy Rice, Phoebe M. Long, Lorraine Greaves, Joan L. Bottorff, Nancy Poole, Natalie Hemsing

Nursing Presentations

Policies which aim to limit secondhand smoke (SHS) exposure by restricting spaces where people can smoke have been shown to improve population health and garner a high level of support from the public, health professionals and policy makers. Following local, national and international examples, Vancouver’s Board of Parks and Recreation approved a smoke-free by-law for the city’s parks, beaches, and facilities effective September 1, 2010. Research suggests that such smoke-free by-laws, when enacted indoors, may affect men and women in different ways, but little research has examined the effects of such outdoor smoking bans on women and men and other …

Smoking Cessation Outcomes Among Individuals With Substance Use And/Or Psychiatric Disorders, Milan Khara, Chizimuzo T.C. Okoli

Nursing Faculty Publications

Objectives: The population of individuals with substance use (SUD) and/or psychiatric disorders (PD) has a high prevalence of smoking and a consequent increase in tobacco-related morbidity and mortality when compared to the general population. The aim of this study is to examine the outcomes of a program in a real-life setting which takes a tailored approach to smoking cessation among individuals with SUD and/or PD.

Methods: A retrospective chart review of tailored tobacco dependence treatment was performed on individuals with histories of SUD and/or PD attending a Tobacco Dependence Clinic (TDC) program in Vancouver, British Columbia, Canada. Participants of the …

Outcomes Of A Tailored Tobacco Treatment Approach For Individuals With Substance Use Disorders And/Or Psychiatric Disorders, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

Summary of Key Findings

• Smoking abstinence at end of program:
• Intent to treat analysis: 31% (167/540)
• Among program completers: 41% (167/406)

• Significant predictors of abstinence:
• Having a history of an anxiety disorder is predictive of being less likely to quit smoking when compared to having no history of a psychiatric disorder.
• Having a lower CO level at program enrolment was a significant predictor of being more likely to quit.
• Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Gender Differences In Smoking Behaviour And Cessation, Chizimuzo T.C. Okoli, Iris Torchalla, Natalie Hemsing, Lorraine Greaves

Chizimuzo T.C. Okoli

This article reviews the literature to compare differential outcomes among men and women after smoking cessation, assess barriers they may face during cessation and provide recommendation to address gender-specific challenges in smoking cessation interventions. There is some evidence that women achieve lower abstinence rates than men after a quit attempt with nicotine replacement therapy, as well as without pharmacotherapy, and several underlying mechanisms were discussed to account for these findings. These include: (a) women have specific genetic variants that affect pharmacokinetics and pharmacodynamics of the medication, (b) hormonal influences increase nicotine metabolism and withdrawal symptoms, (c) women are more responsive …

Smoking Cessation Among Persons With Co-Occurring Substance Use Disorder And Mental Illness, Chizimuzo T.C. Okoli, Milan Khara

Chizimuzo T.C. Okoli

Aims: A history of either a substance use disorder (SUD) or psychiatric disorder (PD) is associated with tobacco use. However, there is limited information available on tobacco dependence treatment outcomes among individuals with co-occurring SUD and PD. Methods: Data from 202 participants enrolled in a tobacco dependence treatment program in an outpatient clinic setting were analysed. Findings: In multivariate analysis, having a history of SUD only (OR =.11, 95% CI = .02–.76) and having a co-occurring SUD and PD (OR = .13, 95% CI = .02–.81), as compared to having neither, were significant predictors of a lower likelihood of achieving …

Men's Smoking Cessation Interventions: A Brief Review, Chizimuzo T.C. Okoli, Iris Torchalla, John L. Oliffe, Joan L. Bottorff

Chizimuzo T.C. Okoli

Background: Smoking is associated with adverse health effects and significant disease burden among men, making it an important men's health issue. Conversely, smoking cessation is associated with significant reductions in smoking-attributable risk. However, few studies have examined men-specific smoking cessation programs. The aim of our study was to conduct a comprehensive review of the literature to identify men-specific smoking cessation programs to make recommendations about future efforts to develop, implement and evaluate men-centered smoking cessation interventions.

Methods: A comprehensive search of the COCHRANE Library, MEDLINE, and PsycINFO and SIGLE databases was performed. Out of 873 studies that we retrieved from …

Challenges And Strategies In Developing Transdisciplinary Research Capacity, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Definitions of Intradisciplinary, Multidisciplinary, Interdisciplinary, and Transdisciplinary

Challenges in developing Transdisciplinary Capacity

Models of Transdisciplinary Research

Case Example of Transdisciplinary Research Team: The iTAG Team

The Relationship Between Secondhand Tobacco Smoke (Shs) Exposure And Smoking Behaviours: Designing A Program Of Research, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Overview

- Background and Significance

- Study 1: Literature Review Study

- Study 2: SHS Exposure, Nicotine Dependence, and Smoking Cessation

- Study 3: Hair Nicotine as a Measure of SHS Exposure

- Study 4: Effects of Nicotine Exposure from SHS Among Bar and Restaurant Workers

- Study 5: Nicotine Dependence Symptoms among Young Never-Smokers Exposed to SHS

- Study 6: An Examination of the Relationship between Adolescents’ Initial Smoking Experience and their Exposure to Peer and Family Member Smoking

Conclusions and Future Directions

Smoking And Secondhand Tobacco Smoke Exposure: Prevalence, Prevention, Protection, And Treatment, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Prevalence and Disease Burden of Smoking

Strategies for Prevention and Protection

Approaches to Tobacco Dependence Treatment

Example of a Smoking Cessation Program

Trauma, Psychiatric Disorders, Substance Use, And Smoking Among Women, Chizimuzo T.C. Okoli, Nancy Poole, Natalie Hemsing, Karin O'Leary

Chizimuzo T.C. Okoli

Despite decreasing smoking rates among women in the general population, there remain subgroups of women characterized by high nicotine dependence, who remain less able to quit.

One subgroup of women who continue to smoke at rates higher than the general population are those who: have past experiences of trauma, are vulnerable to psychiatric disorders and have substance use problems/addictions.

However, the prevalence of the co-occurrence of trauma, psychiatric disorders, and substance use problems/ addictions, with smoking among women has not previously been synthesized.

The purpose of this study is to conduct a comprehensive review to identify the prevalence of smoking …

Implementation Effectiveness Of Campus Tobacco-Free Policies, Amanda Fallin

University of Kentucky Doctoral Dissertations

Tobacco use and secondhand smoke exposure are leading causes of preventable morbidity and mortality in the United States. Outdoor tobacco smoke exposure conveys many of the same risks as indoor secondhand smoke exposure. Tobacco-free campuses policies are an intervention to promote a positive social norm that encourages smoking cessation, as well as reduces exposure to outdoor tobacco smoke. This dissertation contains a review of the policy implementation literature; findings from a psychometric analysis of the newly developed Tobacco-free Compliance Assessment Tool (TF-CAT) to assess compliance with tobacco-free campus policies; and results of a campus intervention study to promote compliance. The …

Predictors Of Readiness To Initiate Insulin Therapy In Patients With Type 2 Diabetes When Oral Medications Fail To Control Hyperglycemia, Pamela Lynn Phares

Theses and Dissertations--Nursing

Type 2 diabetes (T2DM) has reached epidemic levels worldwide during the past two decades. It affects nearly 26 million adults in the U.S. Advances in both the treatments for T2DM and guidelines for its optimal management are extensive. Despite these advances, barely half of type 2 diabetics achieve recommended glycemic targets.

Specific Aims: The specific aims were to:

1. Describe the available research on clinical inertia and interventions that have been implemented to reduce it.
2. Analyze various behavioral theories that explain and predict self-care practices in diabetes in order to develop a conceptual model on which to base an investigation …

Treatment Outcomes From The Tdc: A Look At Smoking Cessation Among Patients With Co-Occurring Substance Use And Psychiatric Disorders, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings

• Smoking abstinence at end of program:
• Intent to treat analysis: 32.2% (83/258)
• Among program completers: 41.3% (83/201)

• Significant predictors of abstinence:
• Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder.
• Having a lower CO level at program enrolment was a significant predictor of being more likely to quit
• Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Intrapsychic Predictors Of Professional Quality Of Life: Mindfulness, Empathy, And Emotional Separation, Jacky T. Thomas

University of Kentucky Doctoral Dissertations

A growing literature documents the inherently stressful nature of working with persons who are suffering or traumatized, and the potential for the development of stress disorders among social workers and other helpers. Previous studies of compassion fatigue and burnout have provided important information about professional and workplace variables that might influence risk, but little attention has been given to studying intrapersonal skills/abilities that might reduce risk and/or increase resilience and work satisfaction among helping professionals. This exploratory study asked whether levels of mindfulness, empathy, and emotional separation would influence professional quality of life, including compassion fatigue, burnout, and compassion satisfaction. …

An Evidence-Based Toolkit For Human Papillomavirus Vaccine Education Of Female Adolescents In The School Setting, Nancy R. Kloha

DNP Projects

A new vaccine to prevent human papillomavirus infection was approved in 2006 in the United States (U.S.). Uptake of the vaccine has been less than optimal (CDC, 2010c). New venues for promoting vaccine acceptance are needed (Middleman & Tung, 2010). The goal of this capstone clinical project is to create an evidence based toolkit for use by school nurses in educating female adolescents, parents, communities and other healthcare providers about the HPV vaccine.

Schools nurses have daily access to young people in the target group for HPV immunization. A vital component of vaccine acceptance is education of those who are …

A Systematic Approach To Manage Clinical Deterioration On Inpatient Units In The Health Care System, Colleen H. Swartz

DNP Projects

The transformation of health care delivery in the United States is accelerating at unbelievable speed. The acceleration is a result of many variables including health care reform as well as the covariation occurring with adjustments in regulations related to resident work hours. The evolving care delivery model has exposed a vulnerability of the health system, specifically in academic medical centers of the United States. Academic medical centers have established a care delivery model grounded and predicated in resident presence and performance. With changes in resident work expectations and reduced time spent in hospitals, an urgent need exists to evaluate and …