Medicine and Health Sciences Commons^™

An Analysis Of The Clear Horizons Program In Perry County, Kentucky On Smoking Cessation, Julia Kollitz

Lewis Honors College Thesis Collection

Perry County is an Appalachian county located in southeastern Kentucky. The population is 28,473 people (United States Census Bureau, 2020). It is a predominately white community, with 95.9% of people falling in this category, which is higher than the national percentage of 75.8% (United States Census Bureau, 2020). Being a rural county, this community uses few news sources, with the primary outlet being WYMT Eastern Kentucky News. This news outlet is a subset of CBS (WYMT, 2023). When comparing statewide and nationwide data, Perry County does consistently worse. They have a high school graduation rate that is lower than the …

A Cluster Randomized Controlled Trial For A Multi-Level, Clinic-Based Smoking Cessation Program With Women In Appalachian Communities: Study Protocol For The "Break Free" Program, Joanne G. Patterson, Tia N. Borger, Jessica L. Burris, Mark Conaway, Robert Klesges, Amie Ashcraft, Lindsay Hauser, Connie Clark, Lauren Wright, Sarah Cooper, Merry C. Smith, Mark B. Dignan, Stephenie Kennedy-Rea, Electra D. Paskett, Roger Anderson, Amy K. Ferketich

Psychology Faculty Publications

BACKGROUND: The cervical cancer burden is high among women living in Appalachia. Cigarette smoking, a cervical cancer risk factor, is also highly prevalent in this population. This project aims to increase smoking cessation among women living in Appalachia by embedding a smoking cessation program within a larger, integrated cervical cancer prevention program.

METHODS: The broader program, the Take CARE study, is a multi-site research collaborative designed to address three risk factors for cervical cancer incidence and mortality: tobacco use, human papillomavirus (HPV) infection, and cervical cancer screening. Break Free is a primary care clinic-based implementation program that aims to promote …

Smoking-Induced Sex Differences In Clinical Outcomes In Patients Undergoing Mechanical Thrombectomy For Stroke, Jacqueline A. Frank, Kara Jo Swafford, Jill M. Roberts, Amanda L. Trout, Ann M. Stowe, Douglas E. Lukins, Stephen Grupke, Keith R. Pennypacker, Justin F. Fraser

Neurology Faculty Publications

OBJECTIVE: Ischemic stroke is the fifth leading cause of death in the United States. Smoking accelerates the onset of stroke by 10 years. The effects of smoking status on percent change in National Institutes of Health Stroke Scale (NIHSS) score, infarct volume, and edema volume were examined following mechanical thrombectomy for large vessel occlusion in patients with acute ischemic stroke.

METHODS: Subjects (N = 90; >18 years old) were divided into 3 groups based on smoking status: current smokers, previous smokers (defined as having quit >6 months before the ischemic event), and nonsmokers. Percent change in NIHSS score was …

The Emerging Global Tobacco Treatment Workforce: Characteristics Of Tobacco Treatment Specialists Trained In Council-Accredited Training Programs From 2017 To 2019, Christine E. Sheffer, Abdulmohsen Al-Zalabani, Andrée Aubrey, Rasha Bader, Claribel Beltrez, Susan Bennett, Ellen Carl, Caroline Cranos, Audrey Darville, Jennifer Greyber, Maher Karam-Hage, Feras Hawari, Tresza Hutcheson, Victoria Hynes, Chris Kotsen, Frank Leone, Jamie Mcconaha, Heather Mccary, Crystal Meade, Cara Messick

Nursing Faculty Publications

Tobacco use is projected to kill 1 billion people in the 21st century. Tobacco Use Disorder (TUD) is one of the most common substance use disorders in the world. Evidence-based treatment of TUD is effective, but treatment accessibility remains very low. A dearth of specially trained clinicians is a significant barrier to treatment accessibility, even within systems of care that implement brief intervention models. The treatment of TUD is becoming more complex and tailoring treatment to address new and traditional tobacco products is needed. The Council for Tobacco Treatment Training Programs (Council) is the accrediting body for Tobacco Treatment Specialist …

Intention To Quit Smoking And Polytobacco Use Among College Student Smokers, Karen M. Butler, Melinda J. Ickes, Mary Kay Rayens, Amanda T. Wiggins, Kristin Ashford, Ellen J. Hahn

Nursing Faculty Publications

Little is known about polytobacco use in college students. One nationally representative survey indicated 51.3% of tobacco-using college students used more than one product, which may increase risk of tobacco-related disease and premature death. The purpose of this study was to examine the association of intention to quit smoking (ITQS) cigarettes with polytobacco use status, controlling for frequency of tobacco product use and cigarette smoking intensity as measured by cigarettes per day (CPD). Data are from a larger quasi-experimental study conducted at a large state university in the Southeastern United States. Analysis is based on the combined sample of current …

A Randomized Controlled Trial Of A Faith-Placed, Lay Health Advisor Delivered Smoking Cessation Intervention For Rural Residents, Nancy E. Schoenberg, Christina R. Studts, Brent J. Shelton, Meng Liu, Richard Clayton, Jordan Baeker Bispo, Nell Fields, Mark Dignan, Thomas Cooper

Behavioral Science Faculty Publications

Introduction. Rural US residents smoke at higher rates than urban or suburban residents. We report results from a community-based smoking cessation intervention in Appalachian Kentucky.

Study design. Single-blind, group-randomized trial with outcome measurements at baseline, 17 weeks and 43 weeks.

Setting/participants. This faith-placed CBPR project was located in six counties of rural Appalachian Kentucky. A total of 590 individual participants clustered in 28 churches were enrolled in the study.

Intervention. Local lay health advisors delivered the 12-week Cooper/Clayton Method to Stop Smoking program, leveraging sociocultural factors to improve the cultural salience of the program for Appalachian smokers. Participants met with …

Gender, Smoking And Tobacco Reduction And Cessation: A Scoping Review, Joan L. Bottorff, Rebecca Haines-Saah, Mary T. Kelly, John L. Oliffe, Iris Torchalla, Nancy Poole, Lorraine Greaves, Carole A. Robinson, Mary H. H. Ensom, Chizimuzo T.C. Okoli, J. Craig Phillips

Nursing Faculty Publications

Considerations of how gender-related factors influence smoking first appeared over 20 years ago in the work of critical and feminist scholars. This scholarship highlighted the need to consider the social and cultural context of women's tobacco use and the relationships between smoking and gender inequity. Parallel research on men's smoking and masculinities has only recently emerged with some attention being given to gender influences on men's tobacco use. Since that time, a multidisciplinary literature addressing women and men's tobacco use has spanned the social, psychological and medical sciences. To incorporate these gender-related factors into tobacco reduction and cessation interventions, our …

Tobacco Treatment For Individuals With Substance Abuse And Psychiatric Disorders, Chizimuzo T.C. Okoli

Nursing Presentations

Overview of this presentation:

• Discuss smoking among persons with substance use and mental illness
• Present smoking cessation outcomes from an evidence-based program for persons with substance use disorders and mental Illness
• Conclusion with current and future Projects

Evidence-Based Smoking Cessation Treatment For Disparate Populations, Chizimuzo T.C. Okoli

Nursing Presentations

Overview of this presentation:

• Describe Research Group and Program of Research among disparate Populations
• Discuss smoking among persons with substance use and mental illness
• Present smoking cessation outcomes from evidence-based programs for persons with substance use disorders and mental Illness
• Conclusion with current and future Projects

The Vancouver General Hospital Smoking Cessation Clinic: Outcomes From A Specialist Cessation Service Within Cardiology, Milan Khara, Chizimuzo T.C. Okoli

Nursing Presentations

PURPOSE: The purpose of our study is to examine pilot treatment outcomes of an outpatient Smoking Cessation Clinic (SCC) provided within Cardiology Services.

RELEVANCE/CONTEXT: Populations with cardiac conditions often continue to smoke at high rates (up to 62%), even after experiencing life-threatening cardiac events. Smoking cessation can greatly reduce the risk of further occurrence of a cardiac event and associated mortality. However few Cardiology services in Canada offer smoking cessation services and few Cardiologists refer smoking patients to such services. The Vancouver General Hospital’s SCC is housed within Cardiology Services and offers a longitudinal approach to smoking cessation. This …

Smoking Cessation Outcomes Among Individuals With A History Of Psychotic Disorders As Compared To Those Without, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

Background: Psychotic disorders (e.g., Schizophrenia, schizoaffetive disorder) are associated with a higher smoking prevalence (relative to other psychiatric disorders) and smoking attributable mortality. Until recently, little has been done to address the disproportionate smoking in this population. The objectives of our study are to: 1) describe the characteristics of smokers with a history of psychiatric disorders (i.e., none, psychotic, and depressive/anxiety) and 2) examine smoking cessation/reduction outcomes by history of psychiatric disorders.

Methods: Retrospective analyses were conducted from charts of 982 participants accessing a tailored, evidence-based, tobacco treatment program within mental health and addictions services in Vancouver, Canada. Demographics, tobacco …

Understanding And Treating Smoking Among Individuals With A Mental Illness, Chizimuzo T.C. Okoli

Nursing Presentations

• Background and significance

• Reasons for smoking among individuals living with a mental illness

• Smoking cessation treatment for individuals living with a mental illness

Outcomes Of A Tailored Smoking Cessation Program For Individuals With A Substance Use And/Or Psychiatric Disorder, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

BACKGROUND: Tobacco use remains a significant cause of morbidity and mortality globally. Although there has been a 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 history of substance use disorders (SUD) and/or psychiatric disorders (PD). Studies suggest that individuals with SUD’s and PD’s often have disproportionately higher smoking-related mortality. Studies further suggest that in clinical samples an estimated 75% of individuals with PD and up to 90% of individuals with PD concurrently smoke. This high prevalence of smoking among …

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, …

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 …