Print Email
 

Social Determinants of Health

The Case of the Reluctant Smoker

Submitted by Bui, Simonetti, Benson, Malek and Anderson
Published June 15, 201

A 52-year-old man with diabetes, hypertension, hyperlipidemia, and COPD presents to your clinic for a routine visit.  He takes 6 medications in addition to 2 inhalers.  He lives with his wife who is disabled from a motor vehicle accident, and they have 2 children in high school. He has smoked 1 pack per day for the past 25 years, but does not drink alcohol.   He is working for a small manufacturing company for almost 20 years, but with the weak economy, he constantly fears losing his job. His diabetes and hypertension are well-controlled. Your major concern for this visit is his continued tobacco use. Repeated efforts to quit smoking by using nicotine gum, patches, and bupropion have not been successful.  He says, “all the guys at work smoke and it’s hard to be the only guy not doing it.”

Which factor listed below would most likely increase his ability to stop smoking?

  1. Educational materials on how to quit smoking

  2. Acupuncture and hypnosis therapy

  3. Long-term use of nicotine replacement therapy

  4. A smoke-free work place


Which action plan would increase his chance of smoking cessation while taking into account his clearly identified workplace obstacles to doing so?

Fast Fact: Smoke-free worksite policies, such as company property smoking bans and coverage of smoking cessation referrals and resources, help employees reduce or discontinue their use of tobacco.  Implementing smoke-free workplace policies was estimated to be more cost-effective than nicotine replacement therapy. Employers may see benefits in improved workplace productivity and decreases in absenteeism.  Some states and municipalities have adopted 100% smoke-free laws in non-hospitality workplaces, restaurants, and bars.    

Reference

Glasgow RE, Cummings KM, Hyland A. Relationship of worksite smoking policy changes in employee tobacco use: Findings from COMMIT. Tobacco Control 1997; 6(Suppl 2):S44–S48

Osinubi OYO, Sinha S, Rovner E, Perez-Lugo M, Jain NJ, Demissie K, Goldman M. Efficacy of tobacco dependence treatment in the context of a "smoke-free grounds" worksite policy: A case study. American Journal of Industrial Medicine 2004; 46:180–187

Halpern MT, Shikiar R, Rentz AM, Khan ZM. Impact of smoking status on workplace absenteeism and productivity. Tob Control. 2001; 10(3):233–238

Ong MK, Stanton GA. Free nicotine replacement programs vs implementing smoke-free workplaces: a cost-effectiveness comparison. Am J Public Health 2005; 95(6): 969-975




 

Submit content to JGIM

JGIM encourages submission of articles aimed at improving patient care, education, and research in primary care and general internal medicine in all settings. Submissions must be original and not currently under consideration for publication in another peer- reviewed medium (paper or electronic).

Learn How to Submit Here

 

FEATURED ARTICLE

 

Darlyn Victor, MD, Paul Moots, MD and Jacqueline Fischer, MD

October 13, 2016

A 39-year-old African-A....

Read Article
 

Most Viewed Articles

73 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
25 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
31 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF

Most Recent Web Only Content

January

17

On the Penetrating Capacity of Ultrasound

Sarah Bugg

Read Article

December

20

Painful Eruption in a Mountain Biker

Jasna Ikanovic, MD and Animita Saha, MD

Read Article

November

19

Adverse Events In US Hospitals:1 in 3 Admissions Has At Least One Adverse Event

SGIM Evidence-Based Medicine Task Force

Read Article

August

25

Diagnostic Schema

Denise M. Connor, Rabih Geha, Mark Henderson, Jeff Kohlwes

Read Article