Help your patients quit smoking

There is no question that smoking has an enormous toll on not only the physical health of this country, but its economic health as well.

According to the Centers for Disease Control & Prevention (CDC), more than 16 million Americans have some type of disease related to smoking. More than 480,000 Americans die each year from cigarette smoking, including almost 42,000 deaths as a result of second-hand smoke.¹ In terms of economics, smoking costs the United States more than $300 billion a year. This includes both direct medical care for adults (almost $170 billion each year) and lost productivity due to premature death or the effects of second-hand smoke (more than $156 billion each year).¹

Given the keen interest that patients have in various CAM therapies, it should not be surprising that they may look toward it as a means to help them quit smoking. National health statistics show that as many as one-third of Americans have turned to some type of CAM treatment.³ Specifically, CAM use to help with kicking the nicotine habit are more prevalent among lower-income patients. Such treatment can include yoga, meditation, hypnotherapy, and acupuncture.²

Where does CAM fit in?

Although there has been some success at helping patients quit smoking with the use of evidence-based brief interventions within the biomedical fields, there has been little effort to include CAM practitioners in public health efforts to stop smoking.⁴ Research is needed to determine what type of interventions work best when offered by CAM practitioners, as opposed to traditional healthcare providers.

A recent article in JMIR Research Protocols tackled this topic by discussing the initial results of an ongoing effort to train and assess CAM practitioners in use of an online tobacco cessation program.⁴ So far, phase 1 (developing and designing a training website and competency assessment tool) has been completed. Phase 2 (currently underway) is a pilot study of the training and competency tool. Finally, phase 3 will synthesize the data to help produce effective guidelines and training tools for CAM providers to offer web-based, brief interventions to help patients stop smoking.⁴

As part of phase 2, 203 CAM practitioners (63 chiropractors, 78 acupuncturists/traditional Chinese medicine practitioners, and 62 massage therapists) were enrolled in the initial training. Of these, 37 percent passed the training.⁴ The researchers are now gathering three-month follow-up survey data, which will then be analyzed for phase 3.

Although the study is still ongoing, the researchers did note several factors that they feel are important in adapting web-based, brief interventions for smoking cessation for use by CAM practitioners. These include scope of practice, CAM approaches to health and wellness, practice organization and business models, and the availability of insurance reimbursement for such services.⁴

The researchers concluded: “Given marked differences between conventional and CAM practitioners, extant knowledge about factors influencing conventional practitioner adoption of tobacco cessation behaviors cannot be confidently extrapolated to CAM practitioners. The potential impact of this study is to expand tobacco cessation and health promotion infrastructure in a new group of health practitioners who can help combat the continuing epidemic of tobacco use.”⁴

References

1. Smoking and Tobacco Use. Fast Facts. Accessed 1/26/2016.
2. Complementary Health Approaches for Smoking Cessation. Accessed 1/26/2016.
3. Clarke TC, Black LI, Stussman BJ, et al. Trends in the use of complementary health approaches among adults: United States, 2002-2012. Natl Health Stat Report 2015 Feb;10(79):1-16.
4. Muramoto ML, Howerter A, Eaves ER, et al. Online tobacco cessation training and competency assessment for complementary and alternative medicine (CAM) practitioners: Protocol for the CAM Reach Web study. JMIR Res Protoc 2016;5(1):e2.