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Publication Date

12-10-2015

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Advisor: J McAna Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA.

Abstract

The purpose of this Capstone project was to propose a comprehensive smoking cessation program for Thomas Jefferson Narcotic Addict Rehabilitation Program (NARP), Jefferson’s methadone clinic. Opiate dependent, methadone maintained patients have higher smoking prevalence rates and lower smoking cessation rates than the general population. Despite this, the majority of methadone clinics do not have programs in place to assist patients in smoking cessation. This is the case at NARP. Despite staff training in principles of harm reduction as well as the Stages of Change in application to illicit substance use, there is no carry over to nicotine dependence. A survey of NARP patient’s was conducted as part of a needs assessment and 25% of the patients were surveyed. 95% of patients reported smoking (across all gender, racial/ethnic groups the lowest smoke rate was 90%), with an average start age of under 18, across all gender, racial/ethnic groups. With the exception of Latino men, there was a moderate interest in smoking cessation. The proposed smoking cessation program includes identifying all patients who smoke: both new and existing patients and through the use of nicotine dependent scales and smoking algorithms, determine their readiness to stop smoking. Utilizing group and individual therapies, patients will be assisted in moving through the Stages of Change in an effort to increase smoking cessation rates. Publically available curricula will be modified and utilized by clinical staff to achieve this end. The patients and clinical staff will work in tandem with the medical staff in order to facilitate the use of Nicotine/Non-nicotine Replacement Therapies. Evaluation will be based on decreased scores on the nicotine dependence scales as well as follow up surveys on patient report of smoking. The goals of the proposal are to reduce the smoking prevalence of patients, decreasing their risk of smoking attributable health conditions, and decreasing the medical costs of treating smoking attributable health conditions.

Presentation: 25:21

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