Implementation of tobacco cessation brief intervention in complementary and alternative medicine practice: qualitative evaluation

Complementary and Alternative Medicine/Therapy for Tobacco Cessation in India: A Secondary Analysis of GATS-1 and 2

Background

India has nearly 267 million adult tobacco users, with a slowly improving quitting rate. Among the many approaches to quitting the habit, such as counseling, nicotine replacement therapy, nicotine patch or gum, and prescribed allopathic medicines. Complementary and alternative medicine/therapy (CAM), a thousand-year-old practice in India, may also prove to be a potential method in tobacco cessation; however, there is scarce literature on the extent of use of CAM among tobacco users who attempt to quit the habit. Therefore, this study attempts to examine the potential of CAM as a strategy for tobacco control in India.

Material and Methods

We undertook a secondary analysis of the data from both rounds of the Global Adult Tobacco Survey (GATS 2009 and 2016). The dependent variable included in the analysis was the use of traditional medicine as a method for quitting tobacco in three types of users-smokers, smokeless tobacco users, and dual users. The prevalence of CAM use was reported, and Chi-square test was applied to find the factors significantly associated with the use of CAM among tobacco users considering a P value of 0.05 to be statistically significant.

Results

The overall prevalence of traditional medicine use for GATS-1 was observed to be more among dual users (4%), while for GATS-2, it was highest among smokers (3%). For both rounds of the GATS survey, the use of traditional medicine was found to be higher among males, rural residents, users with no education or less than primary education, and the eastern region.

Conclusions

CAM has a promising potential for supporting tobacco cessation provided a concerted effort is undertaken to standardize pharmacopeia and establish robust clinical evidence. In addition, there is a need to create awareness, build the capacity of healthcare providers, and foster academic-industrial research in indigenous Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) systems.

Developing Competency-Based Nursing Treatment for Persons With Tobacco Use Disorder

BACKGROUND

Tobacco continues to have a deleterious impact on health outcomes in the United States. Professional nurses at all levels of practice have an opportunity to be a part of the solution. The development of nurse-specific competencies for treating tobacco use disorder (TUD) disorder is long overdue. A task force of American Psychiatric Nurses Association (APNA) subject matter experts was assembled to engage in the process of reviewing the available peer-reviewed literature and additional evidence-based resources (e.g., professional organization position statement, toolkits, national survey results) to create the Nursing Competencies for Treating Tobacco Use Disorders.

OBJECTIVE

The aim of this article is ultimately to improve patient access to quality, evidence-based TUD nursing care by all nurses who are competent, full partners in TUD multidisciplinary care.

METHOD

Search terms were defined and a scoping search and review of the TUD literature and resources was performed from November 2018 to November 2020.

RESULTS

Over 300 articles and evidence-based resources (e.g., professional organization position statements, toolkits, etc.) were discovered. Thirteen competencies were developed and were internally and externally reviewed prior to APNA Board of Director's approval.

CONCLUSION

TUD competencies have the potential to guide nursing education, practice, and research, allowing nurses to be full partners in the design, development, and implementation of effective TUD treatment.

Factors Impacting on Development and Implementation of Training Programs for Health Professionals to Deliver Brief Interventions, with a Focus on Programs Developed for Indigenous Clients: A Literature Review

This paper reviews the literature on evaluations of brief intervention training programs for health professionals which address one or more lifestyle factors of chronic disease to identify factors impacting on development and implementation of programs. A search was conducted of the literature evaluating brief intervention training programs from 2000–2019 in the databases: Medline, CINAHL, Psychinfo, Academic Premier, Science Direct, Ovid (Including EMBASE and Healthstar), Web of Science and Informit. The content analysis and data extraction were aligned to the domains in the Consolidated Framework for Implementation Research (CFIR) to assist in the narrative synthesis. The search identified eight evaluations of programs targeting multiple risk factors, and 17 targeting single risk factors. The behavioural risk factor most commonly addressed was smoking, followed by alcohol and drug use. Programs consisted of face-to-face workshops and/or online or distance learning methods. Facilitators included availability of sustainable funding, adapting the program to suit the organisation’s structural characteristics and adoption of the intervention into routine client care. For Indigenous programs, the use of culturally appropriate images and language, consultation with Indigenous communities, and development of resources specific to the communities targeted were important considerations.

Advancing health promotion through massage therapy practice: A cross-sectional survey study

The human resources needed to provide health promotion services to improve health behaviors in populations are currently limited. Health promotion and education is included in the definition of massage therapy, and many within the massage therapy profession understand that health promotion and education are a part of massage therapy practice. However, the amounts and types of health promotion activities in massage therapy practice have not been thoroughly explored. The objective of this study was to investigate the current attitudes, practices, and barriers toward providing health promotion in a national sample of practicing massage therapists. A descriptive cross-sectional survey disseminated May to August 2016 to practicing massage therapists in the United States. The majority (90.2%) of the 182 participants agree or strongly agree that it is important for massage therapists to provide health promotion. Therapists with less favorable attitudes about providing health promotion reported more barriers to providing the messages to their patients. Barriers to providing health promotion included a lack of guidelines, knowledge, and skills. Training and guidelines for massage therapists regarding health promotion would be a reasonable next step for future research development. Utilizing massage therapists as health promoters may provide opportunities to deliver more prevention messages to patients which may impact public health.

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Most massage therapists feel health promotion is an important part of massage therapy practice.

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Massage therapists report providing health promotion on approximately 10 specific topics.

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The greatest barrier for health promotion in massage therapy practice is lack of guidelines.

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Those with higher levels of education report greater barriers to health promotion.