Learning Objectives: Identify at least three factors that contribute to the success of a cessation program targeting adult tobacco users from small, economically challenged communities in a rural area.
Abstract: In Vermont’s rural northeastern counties, North Country Hospital (NCH) serves a population with significant economic and educational challenges and a high rate of tobacco use by adults. Additionally, the NCH area experiences a higher COPD death rate (57/100,000 in 1998) than VT (44/100,000) or the US (42/100,000). Since 1999, NCH, through its Community Fund Program and more recently with some grant funding, has provided a tobacco cessation opportunity that offers an 8-session group support course with behavior modification and nicotine replacement therapy (NRT). With ALA training, two cessation facilitators work together and accept groups as large as 20 for their evening course. Discussion includes issues such as preparation techniques, setting a quit date, learning to cope with urges, use and effectiveness of NRT, planning on what to do instead of smoking and celebrating small successes. Distribution of NRT with provider approval is incorporated into the program. The course is offered for a very low fee throughout the year through the NCH Wellness Center. Telephone evaluation is done at six weeks, three months, six months and one year post quit date by an ex-smoker who simultaneously provides support and encouragement. Data show a quit rate of 54% at six weeks, decreasing thereafter, and remaining at about 25% at one year. The length of the program, the support and camaraderie that develop among participants, the availability of NRT at extremely low cost, and the periodic telephone support all add to the effectiveness and popularity of this replicable program for rural areas.
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