Implementing a smoking cessation protocol in type 2 diabetics in a podiatry clinic using the Five A's Model

Abstract

<p>Smoking is an independent risk factor for DMT2 making it essential for providers to address smoking cessation consistently. The purpose of this quantitative, quasiexperimental quality improvement (QI) project was to evaluate if or to what degree the implementation of a tobacco cessation protocol using the Five A&rsquo;s model would impact the patient&rsquo;s motivation, nicotine dependence, and provider compliance with assessing tobacco use in adult diabetic smokers in a podiatry clinic for four weeks in the northeastern United States. The transtheoretical model (TTM) was utilized to evaluate patient motivation to quit smoking and determine appropriate cessation interventions. Data on the motivation to quit was measured by TTM and nicotine dependence was measured by the Fagerstrom Test for Nicotine Dependence (FTND) questionnaire in diabetic adult smokers aged 18 years and older, (<em>n</em>=16) were compared at baseline, two weeks, and four weeks post-implementation of the Five A's model. A paired t-test showed that there was a statistically significant improvement in patient's motivation to quit smoking (<em>M</em>=-2.86; <em>SD</em>=1.29; <em>p</em>=0.003), a substantial decrease in nicotine dependence (<em>M</em>= -1.86; <em>SD</em>=1.41; <em>p</em>=0.001), and 100% of the providers (<em>n</em>=6) were compliant in assessing tobacco use. Based on the results, the Five A's model may result in increased patient motivation to quit smoking as well as a decrease in nicotine dependence. Recommendations include continuation of the program and possible repetition of the project at another clinical site over an extended monitoring period as well as with a larger sample size.</p>