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Time to Quit

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NEW ALBANY, IN While Kentucky is in the process of trying to pass a statewide smoking ban, Indiana has already enacted a Smoke Free Air Law, which took effect in 2012. For Floyd Memorial Hospital & Health Services (FMHHS) in New Albany, Indiana, the law was a start, but FMHHS’ 2013 Community Health Needs Assessment for Floyd County emphasized an ongoing need for smoking cessation and prevention in the community.

The assessment evaluated 150 health indicators to determine where resources are most needed. To create a workable action plan, FMHHS chose to focus on three of the largest health priorities: heart disease, obesity, and cancer, particularly colon, breast, and lung cancers. That action plan included creating three Community Coalitions in the areas of Physical Activity, Nutrition, and Tobacco Cessation and Prevention.

According to the Community Assessment, Floyd County’s incidence of tobacco use, nearly 30 percent, is above the national average. Shannon Carroll, RN, BSN, coordinator of Floyd Memorial’s Healthier Community Initiative, says, “Every indicator for lung health – asthma in impoverished children, lung cancer, pneumonia deaths – is linked to high tobacco use.” The report found correlations in indicators between these high priority health issues: “The incidence of Lung Cancer is linked to many other cancers. It also has direct correlation with lifestyle choices, specifically smoking. Smoking correlates with lung cancer, pre-term and low birth weight babies, and heart disease.”

The Tobacco Cessation and Prevention Community Coalition is made up of 15 to 20 community members, including FMHHS staff, physicians, the Floyd County Health Department, the New Albany Housing Authority, the American Cancer Society, pharmacists, and behavioral health professionals. The Coalition is funded by the Indiana State Department of Health Tobacco Prevention and Cessation Commission and the Floyd Memorial Hospital Foundation.

FMHHS’ Tobacco Coalition has four primary initiatives:

To change public policy.
To integrate smoking cessation strategies into hospital electronic medical records (EMR).
To implement a grant program that provides free facilitator kits for the Cooper Clayton Smoking Cessation program to 10 businesses and/or community sites.
To educate college students, a critical population, on the adverse effects of smoking.

Of the first goal, Carroll says, “You get positive movement on smoking cessation when you change public policy.” The coalition is developing a strategic plan to expand local legislation beyond state law.

In terms of EMR, the hospital has completed integration with their system. The nursing assessment for every patient now includes two questions: 1) Do you use tobacco? and 2) Would you like free help to quit? If the answers are yes, patient contact information is automatically sent to Indiana’s Tobacco Quitline, 1-800-QUIT-NOW.

The Quitline is funded by the master tobacco settlement agreement and offers free behavior management counseling sessions over the phone. Depending on insurance, participants also typically get about two weeks’ worth of nicotine replacement for free. The drawback is each participant only gets a limited number of sessions. “It is good as an initial intervention but somewhat time-limited,” says Carroll. “So the Coalition wants to expand those resources.”

FMHHS will begin offering a Cooper Clayton smoking cessation course to the community in 2014, but the Coalition is taking it a step further. While the Cooper Clayton program is free, the kit for those facilitating the course costs $200. The Coalition has purchased 10 facilitator kits and is implementing a grant program for local businesses/organizations that want to offer the program to their employees. Additionally, the Coalition is working with local pharmacies to provide reduced cost nicotine replacement.

Finally, the Coalition is targeting an important population of potential new smokers – college students at Indiana University Southeast. The group has funded a national online monthly health and wellness magazine that features at least one smoking-related article each issue for students.

With a multi-pronged approach, FMHHS’ Tobacco Coalition is primed to meet the state’s goals for reducing tobacco use in Floyd County in 2015.