I followed Linda Cox, R.N. for the Coshocton County Health Department for one day. Her role is specifically designed for as joint study by the Health Department and OSU to research smoking cessation in Appalachian counties of Ohio. It is a three year study, federally funded by grant from the National Institute of Health and the American Cancer Society.
They provide counseling, nicotine patches, and incentives to quit smoking. The first half of my day with Linda was spent passing out pamphlets to local businesses. The first half of this day was spent distributing brochures to the Western part of Coshocton County, in Warsaw and Nellie. The study already has multiple participants from the Eastern part of the county. Now, they are trying to recruit participants from the Western part of the county to make sure all areas are covered.
They also try to address all socioeconomic statuses. Currently, they are in need of more lower-income participants also. This is a very small, close knit community. I was surprised at the eagerness that business owners accepted the information. In one business, a pet grooming operation, of all places, the owner was very happy to have brochures because not only did she own this business, she also operated a gas station/convenience store in town, which also sold cigarettes.
She stated that even though it would cut down on her cigarette sales, she is more concerned about the welfare of her customers, many of whom regularly voice the desire to quit smoking. She took many brochures for the convenience store, and made sure she had the necessary information to obtain more. However, some store owners are not willing to participate.
On the previous day she had been to the local auto parts store and although they were not disrespectful of her, they refused to allow brochures to be displayed in the store. She stresses that their goal is not to preach to participants, but answer their questions and guide them in finding their own reasons for smoking, wanting to quit and coping mechanisms. This study is also documenting the correlation of depression and smoking. Screening is done by a Lay Health Advisor, (LHA). Participants are not allowed into the program if they are on Chantix, but are allowed to participate if they are on Wellbutrin for depression.
Nicotine patches are not distributed to patient until they have passed initial screening and counseling session. Participants are followed for ten weeks and at the end of the program are awarded a certificate and gift cards for gasoline. The second half of this day was spent doing logs, answering phone calls and planning the next day’s activities.
Although I was not able to meet any of the participants personally, Linda was able to tell me of one 70 year old gentleman who was able to quit smoking after having been smoking his whole adult life. Another participant had multiple addictions, including street drugs, and although she seemed very committed to the program, and was very honest in her drug use, they were unable to contact her for the last three weeks.
These two participants are examples of the wide range of the population being reached with this study. This program meets all of the criteria of the essential elements of public health nursing, as described in Foundations of Public Health Nursing in the Community, (Stanhope, Lancaster).
They conducted a community assessment of smokers in the community and are trying to prevent and stop smoking, providing a safer and healthier community. The data they collect continually monitors their performance, effectiveness and will in the end provide the outcome of the study. Of course, smoking cessation promotes healthy lifestyles, and they provide patches and counseling healthcare services.
The county health department partners with OSU to perform the study and conduct research regarding the smoking cessation. One of the goals of this study is to impress upon the community that they can stop smoking, if they have the resources to help them.
Hopefully when word spreads of people in the program having success in quitting, they will be motivated to try again to stop smoking, using the same methods used in the program. Although my day with Linda was not as fast paced as my job in the ED, I still felt as though tremendous service was being given to the community. If the program is as successful as I think it will be, it may save a few of those people ending up in my ED. References
Stanhope, Marcia., Lancaster, Jeanette. Foundations of Nursing in the Community,3rd edition, 2010. Mosby Elsevier, St. Louis Mo.