Hello, i know you already have done this project. But i want you to do it more specific, more simple , more straight forward.I have to show the reader that i actually did this project on this particular patient for real. i have attached on sample for you from one of my classmates you can take a look at that and include nicotine gum too. this project has to beverystraight forward and easy to underestand.
I have attached the information you need to follow dear.
Mention the patient as PS and he wants to smoke because he has a 10 months old daughter
My patient is a 58 year old Caucasian male who has been smoking a pack of cigarettes
everyday since he was 18-years old. For the past 6 months he has switched to vaping (JUUL
vaporizer) as a “healthier” alternative method. Vaping is his stress relief source of therapy since
his at home life can be at times stressful as well as his occupation working as a pharmacy
technician in a rehabilitation hospital. He has plans to quit smoking but never follows through on
the plan because of his addiction to nicotine and states, “I’ll think about quitting later”. The
correlation of appropriate cessation aids that was discussed with my patient was to speak to a
counselor as well as receive text messages supporting him on his decision to quit smoking.
Robinson et al. (2019) concludes that, “Evidence has shown the combination of behavioural
support and a first line quit smoking medication (e.g. nicotine replacement therapy or
varenicline) as part of the Cut-Down-To-Stop (CDTS) approach can significantly increase rates
of successful quitting”.
Counseling can be useful to my patient in that it can pinpoint triggers or occurrences that
cause him to smoke. The counselor can assist in alternatives to avoid those triggers. I explained
to my patient that selecting a nicotine product chewing gum allows you to choose the flavor you
desire and regulates your nicotine intake throughout the day. It is a helpful way to get a handle
on his nicotine cravings. Chewing gum can give his mouth something to do, which can help
relieve the habit of vaping. Lindson, N., et al. (2019) suggests,“People who cut down their
smoking while using varenicline or a fast acting form of nicotine replacement therapy (NRT),
such as gum or lozenge, may be more likely to quit smoking than people who cut down their
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smoking without using a medicine to help them. Giving people face to face support to cut down
their smoking may help more people to quit than if they are provided with self help materials to
cut down by themselves”.
The prescription nicotine intervention therapies that I suggested is Nicotine nasal sprays
and oral inhalers. The over-the-counter replacement therapies that I would recommend is
Nicotine gum, lozenges, and patches. The expected outcome is that the patient will hopefully
take the steps to quit smoking which will lead to a healthier lifestyle. Hartmann-Boyce et al.
(2018) remarks, “All of the commercially available forms of nicotine replacement therapy
(NRT), i.e. gum, transdermal patch, nasal spray, inhalator, oral spray, lozenge and sublingual
tablet, are effective as part of a strategy to promote smoking cessation. They increase the rate of
long term quitting by approximately 50% to 60%, regardless of setting. These conclusions apply
to smokers who are motivated to quit”.
In my opinion, what I proposed as the main target for my patient is getting him to quit
smoking by setting a target date and develop a strategy to help him quit smoking for good. I
talked to him about having his friends and loved ones be there to help him on his journey as well
as suggested that he meditate and exercise daily as replacements to help overcome the addictive
side of vaping. I encouraged him to speak with a smoking cessation counselor and look into
smoke free texting programs as a motivational guide to his path of a living a healthier life.
Moreover, I planned to get my patient to quit smoking by having him implement the Four D’s to
help him get through his nicotine addiction. I suggested him delay and wait out the urge to
smoke, focus on his deep breathing by breathing in slowly and as deeply as he can, then breathe
out slowly repeating this five times. The third being to drink water by sipping the water slowly
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and holding it in his mouth for awhile. Lastly, the fifth d is distraction by talking to a friend,
focusing on the task he is doing, or getting up and moving around, doing something that takes his
mind off smoking for a few minutes.
I highly advised my patient to speak with a counselor which will help him build a
trustworthy relationship which will allow him to break behavioral habits and find comforting
substitutes. Counseling is a great way to be in the presence of someone who is empathetic and
will give non-judgemental advice which will be a key factor in effectively addressing both the
initial hesitation and difficulty my patient has experienced as part of his quitting process. The
smoking cessation counselor can set progressive goals and build his confidence. As stated in the
article, Adult Smoking Cessation—The Use of E-Cigarettes, concluded that, “Smoking cessation
medications approved by the U.S. Food and Drug Administration (FDA) and behavioral
counseling are effective treatments for quitting smoking, particularly when used in combination”.
The implementation of my program that I demonstrated to my patient is providing a
brochure called Juuling: Addiction in the Palm of your Hand. The brochure specified the health
risks from smoking, side effects of nicotine, why is it important to quit, tips to stop vaping, and
cessation methods. In my opinion, what went well was having him find the trigger to his
smoking and work on it perhaps with a counselor and family members. The factors that did not
go so well in the beginning stages was the patient not being ready to commit to quitting smoking.
I think these outcomes were the cause of him not being able and fully ready to commit to quitting
smoking as well as having the urge to vape when his work and home life was stressful.
Furthermore, a way in which I could improve my project for the future is not to overwhelm the
patient with a plethora of smoking cessation products. I would work with the patient and find
certain products that would be more effective in reducing cravings.
References
Hartmann-Boyce, J., Chepkin, S. C., Ye, W., Bullen, C., & Lancaster, T. (2018). Nicotine
replacement therapy versus control for smoking cessation. The Cochrane database of
systematic reviews, 5(5), CD000146. https://doi.org/10.1002/14651858.CD000146.pub5
Lindson, N., Klemperer, E., Hong, B., Ordóñez-Mena, J. M., & Aveyard, P. (2019). Smoking
reduction interventions for smoking cessation. The Cochrane database of systematic reviews,
9(9), CD013183. https://doi.org/10.1002/14651858.CD013183.pub2
Robinson, J., McEwen, A., Heah, R., & Papadakis, S. (2019). A ‘Cut-Down-To-Stop’ intervention
for smokers who find it hard to quit: a qualitative evaluation. BMC public health, 19(1), 403.
https://doi.org/10.1186/s12889-019-6738-9
A Summary Of Smoking Cessation: A Report Of The Surgeon General -2020 Adult Smoking
Cessation – The Use of E-Cigarettes. Retrieved from https://www.cdc.gov/tobacco/
data_statistics/sgr/2020-smoking-cessation/fact-sheets/pdfs/adult-smoking-cessation-ecigarettes-use-h.pdf
In adults that use vape does prescription nicotine replacement therapies versus using over the
counter replacement therapies affect smoking outcomes?
Pico Analysis:
P: (Population)
My patient is a 58 year old Caucasian male who has been smoking a pack of cigarettes everyday
since he was 18-years old. For the past 6 months he has switched to vaping (JUUL vaporizer) as
a “healthier” alternative method.
I: (Intervention Methods)
The prescription nicotine intervention therapies that I would suggest is Nicotine nasal sprays and
oral inhalers.
C: (Comparison between methods)
The over-the-counter replacement therapies that I would recommend is Nicotine gum, lozenges,
and patches.
O: (Expected outcome)
The expected outcome is that the patient will hopefully quit smoking which will lead to a
healthier lifestyle.
My references can be used as additional resources for future use to support my evidence on how
prescription nicotine replacement therapies versus using over the counter replacement therapies
affect smoking outcomes.
References
Hartmann-Boyce, J., Hong, B., Livingstone-Banks, J., Wheat, H., & Fanshawe, T. R. (2019, June
05). Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549450/
Hartmann-Boyce, J., Chepkin, S. C., Ye, W., Bullen, C., & Lancaster, T. (2018, May 31).
Nicotine replacement therapy versus control for smoking cessation. Retrieved from https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6353172/
Kim, N., McCarthy, D. E., Loh, W., Cook, J. W., Piper, M. E., Schlam, T. R., & Baker, T. B.
(2019, December 01). Predictors of adherence to nicotine replacement therapy: Machine
learning evidence that perceived need predicts medication use. Retrieved from https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6931262/
Lee, P. N., & Fariss, M. W. (2017, April). A systematic review of possible serious adverse health
effects of nicotine replacement therapy. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC5364244/
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