Hahn Ellen J, Bucher Amanda, Wiggins Amanda Thaxton, Rademacher Kathy, Beckett Whitney, Taylor LeeAnn, Darville Audrey, Edward Jean
BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA.
College of Nursing, University of Kentucky, Lexington, Kentucky, USA.
J Rural Health. 2025 Jan;41(1):e70017. doi: 10.1111/jrh.70017.
We evaluated a Community Health Worker (CHW)-Tobacco Treatment Specialist (TTS) model for delivering tailored tobacco treatment counseling and support in a rural, low-resourced county.
This was an exploratory, prospective study of people 18 years or older who used any tobacco product including e-cigarettes or vapes in the past 30 days. The CHW assessed tobacco use, secondhand smoke exposure, and quit history; and collected an expired breath carbon monoxide sample and a brief health history before providing 4-6 in-person or phone-based sessions involving tailored tobacco treatment counseling and support. The CHW connected participants to a prescriber at a federally qualified health care center (FQHC) for cessation medications as needed and/or helped them obtain free or low cost medications as available. Six weeks after intake, the CHW conducted a final in-person assessment, carbon monoxide measurement, and tobacco treatment counseling. We then referred participants to the free Quit line and to their primary care provider or the FQHC for additional treatment.
Median cigarettes smoked per day decreased from 20 at intake to 4.5 at the final visit. Most participants reported at least one or more 24-h quit attempts, and 38% reported they had stopped smoking entirely after the final visit. There was a significant increase in participants' confidence in quitting from intake to final.
Using a CHW-TTS-delivered tobacco treatment approach in a low-resourced rural community demonstrated promise in helping tobacco users quit.
我们评估了一种社区卫生工作者（CHW）-烟草治疗专家（TTS）模式，该模式用于在资源匮乏的农村县提供量身定制的烟草治疗咨询和支持。
这是一项对18岁及以上人群的探索性前瞻性研究，这些人在过去30天内使用过任何烟草产品，包括电子烟或蒸汽烟。社区卫生工作者评估烟草使用情况、二手烟暴露情况和戒烟史；在提供4至6次面对面或电话形式的包含量身定制的烟草治疗咨询和支持的课程之前，收集呼出的一氧化碳样本和简要的健康史。社区卫生工作者根据需要将参与者与联邦合格医疗中心（FQHC）的开处方者联系以获取戒烟药物，和/或帮助他们获得免费或低成本的可用药物。在纳入研究六周后，社区卫生工作者进行了最后的面对面评估、一氧化碳测量和烟草治疗咨询。然后，我们将参与者转介到免费戒烟热线以及他们的初级保健提供者或联邦合格医疗中心以接受进一步治疗。
每天吸烟的中位数从纳入研究时的20支降至最后一次访视时的4.5支。大多数参与者报告至少有一次或多次24小时的戒烟尝试，38%的参与者报告在最后一次访视后他们已完全戒烟。从纳入研究到最后，参与者戒烟的信心有显著提高。
在资源匮乏的农村社区采用由社区卫生工作者-烟草治疗专家提供的烟草治疗方法，在帮助烟草使用者戒烟方面显示出前景。
