Health 5R are relevance, risks, rewards, roadblock
Health care providers carry out the important roles in managing the Smoking Cessation Clinics to achieve its objectives in order to help people stop smoking. However, van Eerd et al., (2017) stated that the physicians show lack of engagement with the antismoking treatment due to the limitation of knowledge regarding the treatments. This problem is seen as a barrier in spreading the smoking cessation campaigns.
Besides, the limited knowledge about the antismoking services led to decrease of self confidence among health care providers in delivering the treatments. They felt lack of experience and confidence, especially to answer the questions from the clients. Meanwhile, a research conducted in Saudi Arabia reported that majority of the health care providers are competent, which includes giving advice on smoking cessation and assisting smokers to quit.
However, there is lack in confidence to arrange the smoking cessation follow up to the clients (Jradi, 2015). The study also stated that the smoking cessation training is inadequate, which can influence the effectiveness of the antismoking treatment. Lack of motivation seems to be a reason that prevent the smokers to quit. Family support can be a motivational tool in helping them. Olenik and Mospan (2017) explained about the 5R’s Model that focuses on the motivations interventions to assist patients who not ready to quit. The 5R are relevance, risks, rewards, roadblock and repetition. Other than that, negative mood also mentioned as a barrier in smoking cessation. When the patients experience depression they tend to increase the withdrawal symptom thus reduce the success rate (Lee, Khoo, Morris, Hanlon, Wee, Teo & Adnan, 2016).
They also show no interest in the smoking cessation counseling (Jradi, 2015). Clients with low level of motivation to quit also influence their self-efficacy. It has affected the cessation and the ability of the clients to maintain abstinence as they feel not confident in their ability to successfully achieve the outcome. The low public awareness on smoking cessation treatments indeed influences the self attitude of the clients on the quitting program that has been developed. According to van Eerd et al.
(2017), the structural factors are mentioned regarding the time required and cost. The smoking cessation clinics offer a follow up treatment for smokers to quit. Ibrahim, Magzoub and Maarup (2016) stated that the more visit to the clinic, the patients will have more exposure to the counselling intervention thus increase the attempt and motivation to stop smoking. The first four week are mentioned as the most challenging phases (Fai, Yen, & Malik, 2016). In a research conducted in Brazil reported that only nearly half of the registered patients in that particular study attended the first consultation.
They give the reason of the difficulty in finding time as the barrier as well as personal health problems and difficulty in transportation (Casado & Thuler, 2017). The cost barrier is an issue if the smokers consider over the counter (OTC) nicotine replacement therapy (NRT). That medication is expensive (van Eerd et al., 2017). However, it is a better treatment to increase the success rate than quit smoking without assistance (Olenik & Mospan, 2017). According to Lee et al.
(2016), behavioral technique which used physical activity (PA) is an adjunct to smoking treatment. The study introduced the Physical Activity Consultation (PAC). It is conducted by a facilitator that closed to the patients for 21 weeks. PAC consists of a face to face consultation session and two follow up phone sessions. Overall, most of the participants successfully stop smoking and have increased in PA.
They considered PA as good to health. It is because they will experience low stamina due to smoking. Besides that, they mentioned that PA can help in overcoming craving and urges to smoke. In an article regarding the smoking cessation readiness and designing a plan, the author mentioned the role of e-cigarettes as one of the methods of quitting (Olenik & Mospan, 2017). E-cigarettes are a handheld electronic device which also known as vape. However the role is widely debated about its pros and cons. But more than half of the physicians recommended e-cigarettes as a tool despite of limited evidence.
The author concluded that e-cigarettes can be considered if only patients cannot or will not use pharmacological options due to insufficient evidence regarding this matter. Jradi (2015) and van Eerd et al. (2017) have been stated about the training and informing the health care providers regarding the treatments and issues of the smoking cessation program. Improvement in evidence based and communication may eliminate the barrier of antismoking campaigns. Patients will have more confidence in receiving the treatment.
The same goes to the health care providers as they will have more courage to provide care and contribute to the increasing success rate. According to Lee et al. (2016), behavioral technique which used physical activity (PA) is an adjunct to smoking treatment. The study introduced the Physical Activity Consultation (PAC). It is conducted by a facilitator that closed to the patients for 21 weeks. PAC consists of a face to face consultation session and two follow up phone sessions.
Overall, most of the participants successfully stop smoking and have increased in PA. They considered PA as good to health. It is because they will experience low stamina due to smoking.
Besides that, they mentioned that PA can help in overcoming craving and urges to smoke. In an article regarding the smoking cessation readiness and designing a plan, the author mentioned the role of e-cigarettes as one of the methods of quitting (Olenik & Mospan, 2017). E-cigarettes are a handheld electronic device which also known as vape. However the role is widely debated about its pros and cons. But more than half of the physicians recommended e-cigarettes as a tool despite of limited evidence. The author concluded that e-cigarettes can be considered if only patients cannot or will not use pharmacological options due to insufficient evidence regarding this matter.
Jradi (2015) and van Eerd et al. (2017) have been stated about the training and informing the health care providers regarding the treatments and issues of the smoking cessation program. Improvement in evidence based and communication may eliminate the barrier of antismoking campaigns. Patients will have more confidence in receiving the treatment.
The same goes to the health care providers as they will have more courage to provide care and contribute to the increasing success rate. In Malaysia, the numbers of smokers who quit showing an increasing of 8%. According to Datuk Seri Hilmi Yahaya, Deputy Minister of Health of Malaysia, mentioned that there is 4,710 smokers have been registered to the antismoking campaigns from January to July 2016. Among that number, 1,223 of them have been successfully quit smoking. Currently, the Ministry of Health of Malaysia has provided 535 Smoking Cessation Clinics which include the primary health clinics, hospitals and various agencies (Rahmatullah, n.d.
). The success of the antismoking campaigns in Malaysia indicates an improvement since the Health Ministry launched the quit smoking service known as MQuit Services in 2016. Other than that, there is evidence regarding the intention of the smokers to quit smoking in the low and middle income countries. The finding showed that 14% of them are in the stage of comtemplation, meanwhile 4% in the preparation phase (Owusu, Quinn, Wang, Aibangbee, & Mamudu, 2017).
The contemplation phase is when the smokers seriously think about changing. While the preparation is the phase that smokers doing a planning for change. This proved that people have the intention to stop smoking, but the success of quitting is depending on the individuals. However, female is mentioned as the most likely to stop smoking if her partner had stopped smoking (Foulstone, Kelly, & Kifle, 2017). The Transtheoretical Model (TTM) is used in this qualitative research.
The TTM is a behavioral change model that developed by Prochaska and DiClemente around 1970s. According to LaMorte (2016), this model is introduced to examine the experiences of smokers to quit. TTM explained that behavior cannot change quickly, but can occur through a process. The health care providers can use this model to promote smoking cessation. TTM described five stages of change which are precontemplation, contemplation, preparation, action and maintenance (Malak, 2015).
Stage 1, precontemplation, is the stage which the client has no thought about changing. However, the health care personnel can take the opportunity to encourage them to start thinking to change and its benefits and also educate them on the information regarding the positive lifestyle behavioral changes. Meanwhile, stage 2, contemplation, is happening when the client seriously considers the advantages and disadvantages of the changes.
The positive lifestyle modifications are portrayed in stage 3, preparation. At this phase, the client prepares for the specific action needed for the betterment. The action phase, which is stage 4, the client implements the changes needed. The clinicians play an important role in giving support and motivation in order to overcome any distraction regarding the changes.
And the last stage, which is stage 5, maintenance, it is described as the client’s efforts to change permanently. It is necessary for the health care professional to provide continued encouragement and support so that the positive changes can be maintained.In the world nowadays, there are many cases take place due to the smoking act of the individual as well as others. Many parties really concern about this incident, including the government. This literature review will explain the factors that associated to the failure of the antismoking campaigns, the strategy to improve the antismoking campaigns and the success rate of the antismoking campaigns. Therefore, this literature review will provide a relevant prove related to the finding.
