A Practice Improvement Project Incorporating Tobacco Cessation Education Into a Doctor of Nursing Practice Program
Abstract
Tobacco use is a global epidemic and is one of the largest public health threats the world
has faced killing over eight million people annually. Smoking-related illnesses cost the United
States $300 billion annually. Unfortunately, only 31% of those attempting to quit smoking in
2015 used evidenced-base cessation treatments. When behavioral and pharmacotherapy are
combined, cessation rates increase by 82%. With tobacco use being the leading cause of U.S.
preventable death and with 70% of tobacco users visiting a primary care facility annually, it is
essential that providers appropriately and accurately address tobacco use and cessation.
This practice improvement project designed tobacco cessation education for
implementation into North Dakota State University’s (NDSU) Doctor of Nursing Practice (DNP)
coursework in a health promotion course for 18 family nurse practitioner students. The online
program, Rx for Change: Clinician Assisted Tobacco Cessation, was completed by the DNP
students. Rx for Change was designed by Purdue College of Pharmacy to educate clinicians
about the negative health effects of tobacco use and enhance providers' knowledge to deliver
comprehensive tobacco cessation counseling services. After completion of the modules, the
co-investigator reviewed tobacco use epidemiology, health effects of tobacco, FDA-approved
pharmacotherapy for tobacco treatment, North Dakota-specific resources, and coding and billing
for tobacco cessation in primary care. Additionally, students participated in interactive patient
scenarios and received a tobacco cessation toolkit for providers.
NDSU DNP students’ (a) motivation and confidence in helping people quit tobacco and
(b) comfort with providing information about cessation medications, programs and services, and
referrals for evidence-based tobacco cessation was assessed through a pre- and 2.5 months post-education
questionnaire. The participants’ (a) motivation and confidence in helping people quit
tobacco and (b) comfort with providing information about cessation medications, programs and
services, and referrals for evidence-based tobacco cessation increased dramatically pre- to post-education
for all questions with the exception of question one in which case all participants
strongly agreed in both the pre- and post-education questionnaire. The results of this practice
improvement project will provide direction for tobacco cessation education for future NDSU
DNP coursework and for incorporation into other DNP or health professions curriculum.