Is exposure to secondhand smoke child abuse? yes

Scientific research over the last decade has increasingly demonstrated that exposure to secondhand smoke is not simply a nuisance; it is deadly. Secondhand smoke exposure causes multiple diseases in children, including asthma and pneumonia, and results in thousands of avoidable hospitalizations. Secondhand smoke exposure is a major cause of sudden infant death syndrome and may cause lung cancer and heart attacks with repeated exposure. No safe level of exposure exists

Savannah River Parkway

Officially it's called the Savannah River Plant, or SRP. Many call it the bomb factory. It is located 15 miles east of Augusta, Ga, where I live and work

Social ... Security.

Winters in North Carolina are always unpredictable. Mild but short summerlike days alternate with cold fronts that seem to bring new batches of colds. Crisp early-morning frosts harbinger an early flu season that strikes with such rapidity its victims know only that the timing is incredibly inconvenient

Affordable Care?

Once a year, Stuart, a long-haul truck driver, visited a physician to get a signature on the forms that allowed him to continue driving his 18-wheeler. Over 8 years, he had never seen the same physician twice, in large part because of a lack of health insurance. Upon seeing him for the first time, I assured him that we could make financial arrangements, and he subsequently became my continuity patient. Two years later, we both looked forward to his impending 65th birthday, allowing Medicare to ease his fiscal health care burdens. His unexpected death made me ponder how a lack of access to affordable health care profoundly affects patients and their clinicians

In Reply

In Reply. The purpose of my essay was to expose the personal shortcomings in the way our society chooses to handle medical malpractice lawsuits

Coming Home

Coming home after vacation is sometimes slightly sad. It's not that your trip was boring or too short. Rather, it's more like a bittersweet dream, when, having suddenly awakened, you are less upset to be awake than sorry you cannot return to your dream

Should clinicians recommend e-cigarettes to their patients who smoke? No

Clinicians should not routinely recommend electronic nicotine delivery devices (ENDS), such as e-cigarettes, to their patients who smoke. The wisdom of this evidenced-based recommendation stems from 4 key issues: inadequate safety, poor effectiveness, little regulation, and an ethical framework to do no harm

Provider satisfaction with an inpatient tobacco treatment program: results from an inpatient provider survey

Background: Hospitalization offers an optimal environment for ensuring that patients receive evidence-based treatment. An inpatient tobacco treatment program can deliver interventions broadly, but minimal research has examined the impacts of a consult program on inpatient providers. The Nicotine Dependence Program at the University of North Carolina has provided an inpatient tobacco treatment consult service since 2010. Objective: The program sought feedback from inpatient providers to examine factors that prompted tobacco treatment consult orders, the impact on provider counseling behavior, provider satisfaction, and suggested program improvements. Design: Providers who had ordered a tobacco treatment consult received an online anonymous survey. Setting: The University of North Carolina Hospital is an academic medical facility with 803 beds and over 37,000 inpatient admissions annually from all 100 counties in North Carolina. Approximately 20% of these inpatients report current use of any tobacco product. Patients/participants: Medical providers who ordered inpatient tobacco treatment consults from July 2012 to June 2013 (n=265) received the survey, with 118 providers responding (44.5% response rate). Results: Almost all providers reported being satisfied with the consult program and believed it was effective. Key factors in provider satisfaction included ease of accessing the service, saving provider time, and offering patients evidence-based tobacco use treatment. The consult program increased the likelihood of providers prescribing tobacco cessation medications at discharge, as well as following up at post-discharge appointments. Conclusion: This is some of the first research to show provider satisfaction, program usage, and outcomes with an inpatient tobacco treatment program and demonstrates the important impact of implementing tobacco treatment services within hospitals

Pilot Implementation of a Wellness and Tobacco Cessation Curriculum in North Carolina Group Homes

(2) Instructors used prior professional experiences and goal setting to facilitate program success and participant engagementDespite a steady decline in smoking rates in recent decades, individuals with mental illness continue to smoke at disproportionately higher rates than the general population. Adults with mental illness are motivated to quit and quit with rates similar to the general population when evidence-based cessation interventions are used. To build an evidence base for a wellness and cessation curriculum aimed at individuals with mental illness, the Breathe Easy Live Well (BELW) program was pilot tested in two group homes in North Carolina in the spring of 2014. Evaluators conducted pre- and post-implementation site visits and interviews with program instructors to assess outcomes as well as barriers and facilitators to implementation. Qualitative analysis of the data indicated that implementation was successful in both group homes, and the following themes emerged: (1) Training and technical assistance provided throughout implementation was sufficient; (3) Fostering positive coping strategies contributed to reports of reduced smoking; (4) Curriculum length may be a barrier to recruitment. Additional results included an increased interest among group home residents in more diligently managing mental illness symptoms and one group home moving the designated smoking area out of the direct path of the entrance/exit. Results of this pilot project suggest that BELW could be a potentially useful tool for group home staff to address health and wellness along with smoking cessation among individuals with mental illness

Intensive Smoking Cessation Counseling for Patients with Cancer

Smoking remains the leading cause of preventable death in the United States. Tobacco use increases the risk of multiple cancers, including lung, oropharyngeal, pancreas, bladder, stomach, and colon. Continued tobacco use following a cancer diagnosis increases the risk of cancer recurrence, new primary cancers, and adverse treatment-related outcomes, including postoperative pulmonary complications, poor surgical healing, and decreased response to chemotherapeutic drugs