The Ways and Reasons for Smoking Cessation

According to the CDC, “nearly 14 of every 100 U.S. adults aged 18 or older (13.7%) currently smoke cigarettes” (Current Cigarette Smoking in Adults in the United States, 2019).

This equates to more than 38 million adults in the U.S. are smokers; this statistic is down from 2005 when 20.9% of adults admitted to smoking more than 100 cigarettes in their lifetime (Current Cigarette Smoking in Adults in the United States, 2019).

Studies have shown that men tend to smoke has a higher percentage than women, and people with higher levels of education and greater incomes tend to smoke at a lesser percentage (Current Cigarette Smoking in Adults in the United States, 2019). Close to one third of smokers tend to have an annual income below 30,000 and approximately half of them have an educational level of high school or less. (Caleyachetty, Lewis, McNeill, & Lenardi-Bee, 2012)

Smoking effects every part of your body, it causes cancer, lung diseases, stroke, diabetes, chronic obstructive pulmonary disease (COPD), heart disease, it can effect an unborn child during pregnancy, and increases a person’s risk for other health problems.

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Smoking not only effects the health and well-being of the smoker but secondhand smoke puts those around the smoker at risk also (Health Effects, 2018). “Secondhand smoke causes stroke, lung cancer, and coronary heart disease in adults. Children who are exposed to secondhand smoke are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth” (Health Effects, 2018).

Most smokers are aware of the dangers of smoking, but the addictive nicotine in cigarettes create strong urges to continue smoking and those urges tend to overshadow the health concerns.

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Smokers can experience nicotine withdrawal symptoms in as few as a couple hours without smoking (West, 2017). Smoking cessation requires “a determined attempt to stop and then sufficient resolve in the following weeks and months to overcome what are often powerful urges to smoke” (West, 2017).

Information about the dangers of smoking can be found almost anywhere, the surgeon general’s warning on the packaging, television, internet ads, healthcare providers, even small children are learning that “smoking is bad” even if they done understand why. Information on how to quit does not seem to be a readily available. It is my goal to provide information and supportive resources to individuals that are interested in quitting smoking or have already made the decision to quit but are unsure how best to accomplish that goal. I want to help them understand that even if they have tried multiple times to quit, there are still options available and help to be found and it’s never too late to quit. “Smokers who stop before their mid-30’s have approximately the same life expectancy as never smokers and after the age of 35 years or so, stopping smoking recovers 2-3 months of healthy life expectancy for every year of smoking avoided, or 4-6 h for every day” (West, 2017).

Smoking cessation is important for smokers of all ages, long time smokers with health complications due to the smoking to need to be educated in the benefits of quitting and the potential improvement in personal health; and smokers that have just started need to be aware of the risks and potential health problems, in a clear and concise way, not just the ambiguous knowledge that smoking is bad for you. The at-risk population that I would target would be adolescents, to be able to help prevent the damage from smoking before it has begun. Most smokers started in their teens and those with friends or parents that smoke are more likely to smoke (Why People Start Smoking and Why It’s Hard to Stop, 2015). Another risk factor includes mental health. “There is a strong relationship between youth smoking and depression, anxiety, and stress” (Youth and tobacco use, 2019).

To increase the chances of successful smoking cessation, it is helpful to understand the reasons people start smoking, why they continue to smoke, and if they are ready to quit smoking. The “5 A’s approach: asking patients if they smoke, advising patients to quit smoking, assessing patients’ willingness to quit smoking, assisting patients quit attempts with medication and counseling, and arranging follow contact” (Pelletier, Strout, & Baumann, 2014) is an approach that can be modified to be used even in the fast paced emergency department (ED). A concern that would need to be addressed while trying to encourage smoking cessation in the ED is that “physicians have previously cited time constraints, perceived lack of patient interest and belief that ED-based counseling is ineffective as barriers to providing smoking cessation counseling” (Pelletier, Strout, & Baumann, 2014). A modified transition of care model to include a smoking cessation consultant/liaison to follow up with patients along with the smoking cessation information that is given with standard discharge instructions would be beneficial. A patient is given instruction about which physician they need to follow up with to continue the care they received in the ED, it would only take moments to include information and educate the patient about the smoking cessation consultant, who with their permission, will follow up with them.

Cultural competence is when “nurses are aware, sensitive, and knowledgeable about another’s culture and have the skills to conduct culturally competent programs” (Murdaugh, Parsons, & Pender, 2019). An example of utilizing this proposal in a culturally competent manner would be that in the ED, smoking cessation geared toward adolescents would be more difficult due to the fact that some parents may not be aware that the teen is smoking and the teen may not communicate openly about smoking in the presence of their parents. Adolescent smoking cessation would be more effective in a school setting, where the student my speak more freely with a school nurse.

“Noncompliance: is generally a term which includes deliberate or intentional refusal by the patient” (Jones, 2016).

“Non-adherence: is generally a term which included unintentional refusal by the patient” (Jones, 2016).

Initially, I would treat a noncompliant patient and a nonadherent patient the same, I would assess thoroughly. I would need to know the underlying reasons for the noncompliance and find a compromise with the patient that they feel is satisfactory and a plan of care they can follow. A nonadherent patient I would need to know the reasons they are unable to follow the plan of care and help find a way to keep them on track.

One research strategy and intervention both that I would use is in the journal article “Exercise Facilitates Smoking Cessation Indirectly via Intention to Quit Smoking: Prospective Cohort Study Among a National Sample of Your Smokers” (Frith & Loprinzi, 2018) The research surveyed young daily smokers between the age of 18-24 all across the U.S. for 2 years.

By using self-reporting surveys, which are convenient, young adults may feel more comfortable answering honestly due to the anonymity but may also answer questions based on the response they think the surveyor is looking for or exaggerate the answers due to embarrassment. This survey asks the average number of hours exercised in a week and whether they planned to quit smoking in the next 30 day. The article mentions that “it has been postulated the both exercise and smoking may competitively stimulate the central nervous system and associated neurocognitive function. Existing research suggests smoking initiates an acute increase in neurotransmitter activity known to positively affect mood state. Specifically, dopamine and opioid release is augmented following smoking behavior.” (Frith & Loprinzi, 2018)

Mental health issues are a risk factor for adolescents to begin smoking, this article mentions that smoking can effect dopamine and opioid release; if exercise can also create the same effect, then exercise could potential help with mental health issues such as depression and anxiety and facilitate the intention to quit smoking.

Smoking cessation is a complex and individual decision. Changes cannot be made until a person is ready to make the changes. When that person is ready to quit smoking my proposal is to have information and guidance available. Whether it is a physician referral for medication, a nicotine replacement, a smoking cessation consultant that can help through out the entire journey, or even referrals for physical or spiritual fitness advice.


  • Caleyachetty, A., Lewis, S., McNeill, A., & Lenardi-Bee, J. (2012, Feb). Struggling to make ends meet: exploring pathways to understand why smokers in financial difficulites are less likely to quit successfully. European Journal of Public Health, 22, 41-48.
  • Current Cigarette Smoking in Adults in the United States. (2019, November 18). Retrieved from Center for disease control and prevention:
  • Frith, E., & Loprinzi, P. D. (2018, June). Exercise facilitates smoking cessation indirectly via intention to quit smoking: prospective chohort study among a national sample of young smokers. American Journal of Health Promotion, 32(5).
  • Health Effects. (2018, Feb 8). Retrieved from Center for Disease Control and Prevention:
  • Jones, S. (2016, May 11). Cooperative of American Physicians. Retrieved from The noncompliant vs the non-adherent patient:
  • Murdaugh, C. L., Parsons, M. A., & Pender, N. J. (2019). Health promotion in nursing practice (Eighth ed.). Boston, MA: Pearson.
  • Pelletier, J. H., Strout, T. D., & Baumann, M. R. (2014). A systematic review of smoking cessation interventions in the emergency setting. American journal of emergency medicine, 713-724.
  • West, R. (2017, Aug). Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychology & Health.
  • Why People Start Smoking and Why It’s Hard to Stop. (2015, Nov 13). Retrieved from American Cancer Society:
  • Youth and tobacco use. (2019, Dec 10). Retrieved from Center for Disease Control and Prevention:

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The Ways and Reasons for Smoking Cessation. (2021, Sep 08). Retrieved from

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