1. Ukeme A. Udoh University of the District of Columbia
Matrix 2
Ukeme A. Udoh
University of the District of Columbia

2. HEALTH DISPARITY IN SMOKING TOBACCO
Can hospitals stop their Employees and patient and visitors from smoking anywhere?

3. OBJECTIVES Discuss the health hazards associated with smoking
To review and discuss effect of smoke free policies within the health care facility.
Statistical data from smoke related deaths
Show a clinical proposal to evaluate tobacco use and tool to prevent smoking
Articulate goals and objectives of the selected tool
Provide rationale for the choice of tool
Your objectives for creating this tool have to be specific. Please use the list of action verbs.
Make certain that the sections of the tool are supported by the five articles of matrix one.

4. INTRODUCTION
Smoking tobacco is a national health epidemic that claims the lives of many individuals annually
(American lung association,2012)
This is particularly alarming due to the preventable nature of smoking
While many individuals who smoke have expressed the desire to quit, only a few percent who attempt to stop without a formal intervention
Too much information inserted in the slide. Just bullets please.

5. LITERATURE REVIEW
Literature 1. Smoke free policies have a cumulative effect on smoking behavior (Berg et al, 2012)
Literature 2: A campus wide smoke-free policy has no detrimental effect on measures of employee or consumer attitudes / behaviors (Christine et al, 2009)
Literature 3: Smoke free policies around the hospital property have consequences, support for withdrawal important (Annette et al, 2011)
Literature 4: Smoke bans reduce employee tobacco use (Wheeler, 2007)
Literature 5: State legislation do play a positive role in facilitating health related policy change (knudsen,2010)
Same comments

6. A WELLNESS PHILOSOPHY
To assist people to lead meaningful lives in their communities, we need to promote behaviors that lead to good health (primary prevention)
Same comments

7. TOBACCO’S DEADLY TOLL
More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined
435,000 deaths in the US/year
4.8 million deaths worldwide/year
10 million annual death estimated by 2030
50,000 annual deaths in the US due to second hand smoke exposure
(Tobacco-Related Mortality, 2011)
The font has to be higher

8. TOOL A: NICOTINE DEPENDENCE
1. How many cigarettes a day do you usually smoke?
[ ] points
[ ] 11 – 20 1 points
[ ] 21 – 30 2 points
[ ] 31 or more 3 points
2. What type do you smoke? 0 points
[ ] Low nicotine (0.9 mg or less) 1 point
[ ] Medium nicotine (1.0 – 1.2 mg) 2 points
[ ] High nicotine (1.3 mg or more) 3 points
3. How often do you inhale the smoke from your cigarette?
[ ] Never 0 points
[ ] Sometimes 1 points
[ ] Always 2 points
4. How soon after you wake up do you smoke your first cigarette?
[ ] Within less than 5 minutes 3 points
[ ] Within 6-30 minutes 2 points
[ ] Within minutes 1 points
5. Do you smoke more during the first two hours of the day than during the rest of the day?
[ ] No 0 points
[ ] Yes 1 points
6. Which cigarette would you most hate to give up?
[ ] The first cigarette in the morning 1 point
[ ] Any cigarette other than the first one 0 points
7. Do you find it difficult to refrain from smoking in places where it is forbidden, such as public
buildings, on airplanes or at work?
[ ] Yes 1 point
Mention the fact that your tool is composed of 3 sections. Specify the recipients- Where and when the tool will be given-Split this into two- give rationales for the questions.

9. TOOL B: SELF EVALUATION STAGE
SELF EVALUATION Tobacco Use & Quitting
Please mark the spot that reflects how important it is for you to change your tobacco use?
Not Important Very Important Not Confident Very Confident?
Please mark the point that reflects how confident you are that you can change your tobacco usage.
On the following scale, which point best describes how ready you are at this time to change your tobacco habit?
Same comments

10. TOOL C: CLINICAL PROGRAM: EVIDENCE BASED MODEL
Ask: Systemically identify all tobacco users
Advise: Advise tobacco users to quit
Assess: Assess each tobacco users willingness to quit
Assist: Assist tobacco users with a quit plan
Arrange: Arrange follow-up contact
(Jamal et al, 2012)
Same comment

11. SHORT TERM GOAL AND OBJECTIVE OF SLECTED PROGRAM
To improve awareness, knowledge and attitudes related to cessation among adult smokers.
To improve awareness, knowledge and attitudes related to cessation among health care system staff, health care professionals and insurance purchaser
Promote decreased social acceptability of tobacco use
Promote health system change

12. LONG TERM GOAL OF SELECTED PROGRAM
Increase the percentage of smokers who intend to quit
Decrease smoking rate among pregnant women
To Encourage health care providers to counsel patients to quit using tobacco
To promote smoke cessation programs in workplaces and other community setting

13. RATIONALE FOR PROGRAM SELECTED
The tool is simple and easy to use
It creates a follow up relationship between the physician and patient.
As a clinical practice guideline, tool addresses areas and enables the HCP to teach patients on the importance of quitting
Consistent use of this tool increases health care provider knowledge and skill in dealing with tobacco dependent adult
Rationales for each section of the tool as well.

14. References
American lung association. (2012). Retrieved from
/stopsmoking/aboutsmoking/healtheffects/smoking.html
Berg, C., Swan, D., Fredrick, G, Daniels, S., & Kegler, M., (2012) Smoke-
free Policies at home, church and work: Smoking levels and recent quit
attempts among a southern rural population Prevention chronic
disease 1-9
Jamal, A., Dube, S. R., Malarcher, A. M., Shaw, L., & Engstrom, M. C. (2012,
june 15). Tobacco Use Screening and Counseling During Physician
Office Visits Among Adults — National Ambulatory Medical Care
Survey and National Health Interview Survey, United
Tobacco-Related Mortality. (2011). Retrieved from Center for Disease Control
website

15. References
Annette S.H Schultz, B. F. (2011). A qualitative investigation of smoke free policies on hospital property. CMAj.JAMC, 1-9
Christine Shaffer, M. S. (2009). Smoke Free Medical Facility Campus Legislation: Support, resistance, difficulties and Cost. International journal of Environmental research and Public Health, 1-6.Incomplete
Hannah k. Knudsen, S. (2010). Substance Abuse Treatment Counselors and Tobacco Use: A Comparison of Comprehensive and Indoor only Workplace Smoking bans. Oxford Journals o Nicotine and Tobacco Research, 1-4 ( Use APA to provide enough information here for the reader to retrieve the source of your entry).(volume, issue)
J Gary wheeler, l. P. (2007). Impact of a Smoke Free hospital Campus Policy on Employee and Consumer Behavior. Public Health Reports, 1-6.
Revisit your APA manual. Your references have to include enough information for the reader to retrieve the sources