smoking cessation program

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Needs Assessment

Lung Cancer is the leading cause of cancer related deaths in both men and women in

the U.S. In 2009, more than 205,974 people were diagnosed with lung cancer, nearly 159,000

people dies from lung cancer , and an estimated 228,190 people are estimated to be diagnosed

with lung and bronchus cancer on 2013 (National Cancer Institute, 2013). In 2009 in the state of

Florida alone 66.0 per 100,000 people were diagnosed with Lung Cancer compared to 64.3 per

100,000 people in the United States. All these stats correlate to being the number one ranking

cause of cancer death in the state of Florida with 48.2 per 100,000 people dying of Lung cancer

(Center for Disease Control, 2009).The number one risk factor for lung cancer is smoking. The

risk of lung cancer associated with cigarette smoking are dose dependent and increase markedly

by the number of cigarettes smoked per day and numbers of years smoked. (National Cancer

Institute, 2013). According to the county health ranking website, the socioeconomic gradient in

smoking prevalence is well documented with significantly high rates of smoking found in lower

socioeconomic positions. These factors include low education attainment, unemployment, social

isolation and mental illness, described as disadvantage smokers (Bryant, Bonevski, Paul, Hull,

O'Brien, 2013). This is where the program will focus efforts. A sample of 100-200 people in the

lower socioeconomic positions as described before will be surveyed for our needs assessment.

The programs sample shall be selected from current clients in the Duval county health

department. For our needs assessment we will survey people from the Clay county area who are

current clients at the Clay County Health Department. According the County Health Rankings,

(2013) Clay and Duval counties share similar statistics for adult smoking with Duval at 20% and

Clay at 23%. A survey will be given to each client that is seen at the medical clinic at the Clay

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County Health department. The survey will collect data such as tobacco product use, frequency,

and demographics. The survey will include questions such as “How long have you used tobacco

products?”, “What kind of tobacco products do you use?”, “How many cigarettes do you smoke

a day?”, “Have you tried to quit smoking in the past?”, “What are some of the obstacles you

encounter when trying to quit?”, and “What best describes your race/ethnic identity and

gender?” The survey will be handed out over the course of a month and data will be collected.

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References

Bryant, J., Bonevski, B., Paul, C., Hull, P., O'Brien, J. (2012) Implementing a smoking cessation

program in social and community service organizations: A feasibility and acceptability trial. Drug

and Alcohol Review, 31, 678-684. doi: 10.1111/j.1465-3362.2011.00391.x

Center for Disease Control. (2009). Incidence rates: Florida. Retrieved from

http://apps.nccd.cdc.gov/uscs/statevsnational.aspx

National Cancer Institute. (2012). What you need to know about Lung Cancer. Retrieved from

http://www.cancer.gov/cancertopics/wyntk/lung/page4

National Cancer Institute. SEER Stat Fact Sheets: Lung and Bronchus. 2013;

http://seer.cancer.gov/statfacts/html/lungb.html.

http://seer.cancer.gov/statfacts/html/lungb.html



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Lung Cancer has been and still is one of the most leading causes of preventable death in the

United States, second only to Heart Disease. Cancer begins in the cells that make up tissues and organs

in the body. Sometimes the process is faulty. New cells are formed when not needed and old and

damaged cells don't die off, these cells build up and form growths or tumors. The most common types of

Lung Cancer are Small Cell and Non-small cell. They are named after what they look like under a

microscope. About 1 in 8 people with Lung Cancer has small cell lung cancer which grows and spreads

faster than the other. They are treated differently, and small cell grows and spreads faster than the

other (National Cancer Institute, 2012). From 1999-2004 a total of 1,095,305 lung and bronchial cancer

cases, 69.4 per 100,000 persons, were diagnosed in the United States. Lung Cancer is the second most

commonly diagnosed cancer in men and women after prostate and breast cancer and is the leading

most cause of cancer death in the United States, Stewart et al. (2008). In 2009 in the state of Florida

alone 66.0 per 100,000 people were diagnosed with Lung Cancer compared to 64.3 per 100,000 people

in the United States. All these stats correlate to Lung Cancer being the number one ranking cause of

cancer death in the state of Florida with 48.2 per 100,000 people dying of Lung cancer (Center for

Disease Control, 2009). Based on these rates nearly 6.88% of men and women today will be diagnosed

with cancer of the lung and bronchus during their lifetime. This can be expressed as 1 in 15 men and

women will be diagnosed with cancer of the lung and bronchus. From 2006-2010 the median age at

which lung cancer was diagnosed was 70 years of age, the median age at death of lung and bronchus

cancer was 72 years of age (National Cancer Institute, 2013). That's a mere 2 years between diagnosis

and death. QOL concerns with cancer are numerous. Treatments for lung and bronchus cancers are very

invasive and damaging to the body. Most treatment consists of target radiation and chemotherapy.

Surgery to remove the tumor if possible is another alternative with a dose of radiation. Quality of life

concerns include, depression and emotional disarray, weight-loss, weakness, and loss of appetite are

common among those undergoing treatment for lung cancer. In 2013 an estimated 228,190 new cases

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of lung cancer are expected in 2013. This number accounts for about 14 % of cancer diagnosis. Lung

cancer is the leading cause of death among men and women, more than any other cancer. It is

estimated that 159,480 deaths will occur, accounting form 27% of all cancer deaths in 2013 (American

Cancer Society. 2013).

Male are at risk more than females as the incidence rates show that 74.3 per 100,000 males

against 51.9 per 100,000 females are at risk of diagnosis of lung Cancer, with the death rate showing

males on top at 63.5 per 100,000 males versus 39.2 per 100,000 females (National Cancer Institute,

2013). If you look further into the data we find that the socioeconomic gradient in smoking prevalence

is well documented with significantly high rates of smoking found in lower socioeconomic positions.

These factors include low education attainment, unemployment, social isolation and mental illness,

described as disadvantage smokers (Bryant, Bonevski, Paul, Hull, O'Brien, 2013). Given these factors

work synergistically there are strong grounds for providing cessation programs that target disadvantage

smokers.

These numbers are astounding considering that the primary risk factor for lung cancer is

cigarette smoking. With the 1964 Surgeons General report and every surgeons general report thereafter

has included evidence on smoking and lung cancer. A large quantity of scientific evidence clearly

showing cigarette smoking causes lung cancer (National Cancer Institute and the National Institute of

Health, 2013). Approximately 2.4 million cases of tobacco-related cancer were diagnosed in 2004-2009

with lung and bronchial cancer rate being 69.4 per 100,000 persons. The risk of lung cancer associated

with cigarette smoking are dose dependent and increase markedly by the number of cigarettes smoked

per day and numbers of years smoked. Current smokers have approximately 20 times the risk of lung

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cancer than nonsmokers. Based on this evidence smoking avoidance would result in decreased mortality

and incidence from primary lung cancers (National Cancer Institute, 2013). According to the county

health ranking website, (http://www.countyhealthrankings.org/) 20% of residents in Duval county

smoke compared to 19% of residence in the whole state of Florida. CDC recommends programs that

promoting smoking cessation. Quitting by age thirty eliminates nearly all excess risk associated with

smoking and those who quite before age 50 cut in half risk of dying in the next 15 years.

Recommendations for more intensive interventions such as individual, group or telephone counseling

that provide support and coaching on problem solving are more effective. Recommendations from past

programs agree that a combination of counseling and medication intervention is most effective to

initiate behavior change and accomplish smoking cessation (Center for Disease Control and Prevention,

2007). Findings support that intense cessation programs involving a combination of intense counseling,

phone support and medication intervention to disadvantage smokers, as described earlier, may help

reduce the burden of smoking related morbidity and mortality that falls on the lower socioeconomic

position and provides a novel setting for providing cessation support Bryant et al. (2012).

The purpose of my program is to reduce the prevalence of Lung Cancer death from 50.6 deaths

per 100,000 population to 45.5 per 100,000 population. This objective was attained from the Healthy

people 2020 objectives. The number one risk factor for lung cancer is smoking and as discussed through

this paper smoking has a direct correlation with lung cancer. Smoking cessation has a direct link to

reduction in morbidity and mortality rates. Data shows that men have a higher rate of lung cancer

diagnosis then women and a higher mortality rate. There is a high rate of smoking among the lower

socioeconomic and disadvantage population, Glover et al. (2004). Suggestions for gathering this

targeting population which includes males above age 45 of the lower socioeconomic level would be

http://www.countyhealthrankings.org/

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through local community service organizations such as local behavior health centers for mental health

and the local Health departments, Bryant et al. (2012). The program will provide education on lung

cancer and its risk factors including education on smoking cessation. It will include a form of group

therapy and mediation therapy, such as nicotine replacement, to help with smoking cessation, as studies

have shown that both therapy and medication help in changing behaviors and accomplishing smoking

cessation.

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References

American Cancer Society. (2013). Cancer Facts & Figures 2013. Retrieved from

http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/

document/acspc-036845.pdf

Bryant, J., Bonevski, B., Paul, C., Hull, P., O'Brien, J. (2012) Implementing a smoking cessation

program in social and community service organizations: A feasibility and acceptability trial. Drug

and Alcohol Review, 31, 678-684. doi: 10.1111/j.1465-3362.2011.00391.x

Center for Disease Control. (2009). Incidence rates: Florida. Retrieved from


Center for Disease Control and Prevention. (2007). Best Practices for Comprehensive Tobacco

Control Programs. Retrieved from:

http://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2007/

BestPractices_Complete.pdf

Glove, JD., Hertzel, D., Tennant, S. (2004). The Socioeconomic gradient and chronic illnesses and

associated risk factors in Australia. Australia and New Zealand Health Policy 1, 1-8

Hitsman, B., Moss, T., Montoya, I., George T. (2009). Treatment of tobacco dependence in

mental health and addictive disorders. Canadian Journal of Psychiatry 54, 368-378

National Cancer Institute. (2012). What you need to know about Lung Cancer. Retrieved from


National Cancer Institute and the National Institutes of Health. (2013). Lung Cancer Prevention

(PDQ). Retrieved from:

http://www.cancer.gov/cancertopics/pdq/prevention/lung/HealthProfessional

http://www.cancer.gov/cancertopics/pdq/prevention/lung/HealthProfessional


http://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2007/BestPractices_Complete.pdf

http://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2007/BestPractices_Complete.pdf


http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036845.pdf

http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036845.pdf

P a g e | 9

National Cancer Institute. SEER Stat Fact Sheets: Lung and Bronchus. 2013;

http://seer.cancer.gov/statfacts/html/lungb.html.

Stewart, S., Cardinez, C., Richardson, L., Norman, L., Kaufmann, R., Pechacek, T., Thompson, T.,

Weir, H., Sabatino, S. (2008). Surveillance for Cancers Associated with Tobacco Use --- United

States, 1999—2004.

http://seer.cancer.gov/statfacts/html/lungb.html

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Mission statement, Goal, and Objectives

Mission Statement: This program is aimed at helping adults understand the risks of lung cancer,

provide alternatives to smoking, and reduce smoking among the population of Duval County and to

increase quality of life concerns in the adult population at risk for lung cancer.

Goal: To reduce the incidence of Lung Cancer caused by tobacco smoking in Duval County

Process Objective: At programs end, the program will receive a “Very Good” rating

among three quarters of the participants.

Behavioral Objective: Three months after the programs, 20% of participants will have

quit smoking.

Learner Objective: By the end of the Program 80% of participants will be able to list

three risk factors of lung cancer

Program Objective: Within five years after the program, Lung Cancer will incidence will

decrease by 10% in Duval county.

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Health Belief Model Worksheet

Concept Definition Application Specific activities that will address these (for your project)

Perceived Susceptibility

One’s opinion of chances of getting condition

Define population(s) at risk, risk levels. Personalize risk based on a person’s features or behavior. Make perceived susceptibility consistent w/ actual risk.

Provide in a class and brochure/handout statistics on risk factors of lung cancer such as age, race, gender and use of Tobacco products, data on national and local level on lung cancer incidence,

Perceived Severity One’s opinion of how serious a condition and its consequences are

Specify consequences of the risk and the condition.

Provide in a class and brochure/handout statistics on mortality rates, severity of health concerns and quality of life concerns.

Perceived Benefits One’s opinion of the efficacy of the advised action to reduce risk or seriousness of impact

Define action to take: how, where, when; clarify the positive effects to be expected.

Provide in a class and brochure/handout the benefits of smoking cessation, increased health benefits, and quality of life benefits.

Perceived Barriers One’s opinion of the tangible and psychological costs of the advised action

Identify & reduce barriers through reassurance, correction of misinformation, incentives & assistance.

Provide information on smoking cessation, nicotine alternatives such as medication and nicotine replacement. Provide samples during class.

Cues to Action Strategies to activate “readiness”

Provide how-to information, promote awareness, reminders.

Discuss during class setting addiction, cravings, stressors and triggers that promote

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smoking. Discuss skills to deal with stressors and triggers.

Self Efficacy Confidence in one’s ability to take action

Provide training, guidance in performing action, progressive goal setting, and reinforcement, demonstrate behaviors, and reduce anxiety.

Provide Brochure materials during class setting on the National quit-line, setting a quit date and cessation plans to quit or reduce use of cigarettes and tobacco products.

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Program Activity / Intervention

Materials needed

Laptop (power point presentation of the brochure information )

Projector screen

Projector

Informational Brochures (info on risk factors, statistics, mortality rates, health concerns and QOL

concerns of lung cancer, health benefits of smoking cessation, cessation plan info, National Quit

line numbers).

Cessation plan Models

Setting

Classroom setting

Time needed

45 minutes

Program Activity (Program Introduction Class)

(Learner Objective / Learner Objective) This activity shall be one of 4 introductory classes to the

program. In a class room setting the program lead shall introduce himself to the participants and have

the participants introduce themselves. The lead shall distribute the educational handout to the

participants. The first 15 minutes of the program introductory class shall include: a thirty second

YouTube video chosen for its simple, short but to the point shock factor content

http://youtu.be/OO2nGxbAyvE , the introduction of simple statistical data about lung cancer in the

Duval county area, followed by the risk factors of lung cancer including smoking being the number one

http://youtu.be/OO2nGxbAyvE

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risk factor. The lead will then present the mortality rates for lung cancer among smokers and introduce

the quality of life concerns about lung cancer and the health benefits of smoking cessation including

personalizing it in such a way that includes factors about the future, seeing their children and

grandchildren grow up, to impart knowledge and be there for them, this is designed to play on the heart

strings of the participants and entice them to want to change behavior and attend the programs

cessation and support classes that start then next month. The participants shall be able to follow along

as all this data and education will be on the educational handout.

For the next 15 minutes the program class lead shall introduce and discuss some common

known barriers to smoking cessation such as medical and financial barriers. The lead will discuss how the

program plans to work with the participants in problem solving and dealing with the barriers through bi

weekly classroom session each month. The lead shall explain to the participants that the program will

have a cessation specialist who will work with the participants to develop a “plan to quit”, set quit dates

and goals, and that the program will provide free samples of nicotine replacement products. The lead

shall explain the bi weekly session will have trained support coaches to help the participants in a support

group setting during the bi weekly meetings.

The last 15 minutes of the program introduction class the lead shall introduce to the participants

the samples of the cessation material that are to be used in the program. This includes information such

as cessation plans ,that can help plan and direct cessation attempts and setting a quit date, brochure

material that gives information on the National Cancer Institute quit line and state quit lines that

participants can call and speak to trained counselors and coaches who can provide advice, support, tips

and help with smoking cessation.

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Upon class end advise the participants to really think about the information given to them today

and to talk with their family about it, get their support to help push them farther in their decision and

ultimate end goal to end smoking and help prevent lung cancer and decrease their QOL concerns. Wish

them a good day and make sure to give them the date of the start of the first cessation and support

class which will begin the first week of the next month.

Class End

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Materials needed

Cessation plan materials

Laptop (power point of cessation plan)

Projector

Projector Screen

Brochure for NCI and its quit line information

Nicotine and tobacco replacement samples (Nicotine gum, Nicotine patch, Nicotine lozenges)

Setting

Classroom

Time needed

60 minutes

Program Activity (Cessation and Support Class)

(Behavior Objective / Learner Objective) The class shall be led by a cessation specialist and 3

support cessation coaches. For the first 5 minutes of the class the specialist will briefly go over risk of

lung cancer and key in on smoking being the number one risk factor. This will be repeated at the start of

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each class form here on out to hammer home to risk factors associated with Lung cancer, to strive for

the point of the cessation program and to help accomplish our learner objective.

The next 10 minutes of class shall be spent with the cessation specialist trying to make the

program personal for the participants by going over “Reasons for quitting”. This shall include areas such

as:

Your health and Appearance:

My chances of having cancer, heart attacks, heart disease, stroke, cataracts, and other diseases

will go down

I will be less likely to get sick

I will breathe easier and cough less

My blood pressure will go down

My skin will look healthier, and I will look more youthful

My teeth and fingernails will not be stained

Your Lifestyle:


will go down






Your Loved Ones


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will go down






The point is for the participants to make a list of all of the reasons they want to become smoke free and

keep it in a place where you will see it often, like their car or where they keep their cigarettes it’s there

to remind them why they want to quit. This information will be followed by the participants on the

power point presentation and will be done for only the first two classes in the second month of the

program (the first and the second cessation and support class). Thereafter the 10 minutes will be used

to expand more time for the support group portion of the class.

The next 10 minutes of class the cessation specialist will go over the cessation plan with the

participants. The participants will have a handout with the cessation plan on it. The plan is as follows.

Pick a quit date: Circle it on the calendar; it will remind you of your decision to quit.

Let loved one know your quitting: support is important and key to success

Remove reminders of smoking: remove, matches, lighters, ashtrays, clean car and home

Make a reason for quitting list: a reminder so when u feel an urge, look at it.

Identify triggers: Write down what makes u feel likes smoking, list a way to deal or avoid.

Coping strategies: nicotine replacement

Plan for Immediate support: Use the quit lines, or the Quit smoking apps, support groups, meds

Set up milestone reward: Treat yourself once you hit a milestone, 2 weeks or 1 month, buy

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yourself a nice dinner or something you’ve been wanting.

This is the quit plan the program shall follow. Each Participant shall work on their quit plan on their

own outside of the class so when they come to the next class they have a plan, as they continue

through he program plans may need to be adjusted or tweaked this will be handled in the support

group at the end of the class.

The last 30 minutes of class (for the first two cessation and support classes only, thereafter it will

be 40 minutes starting with the third class) will be used to break the participants up in to smaller

group of equal numbers among the 3 cessation coaches and the 1 specialist. Each will conduct a

support group style meeting with their group of participants. Here they will discuss stressors,

triggers, and cravings that lead to wanting to smoke and slips. They will help with these areas by

teaching coping skills, problem solving skills, and medications to apply to counter these stressors

and triggers. The group lead will supply the free samples of nicotine replacement for the participants

if wanted and discuss their uses and the pros and cons of each. The group lead will introduce their

participants to the free mobile applications that can provide help and support in times of cravings or

needs. These applications are QuitSTART app, NCI QuitPal App, and QuitGuide app all found on your

mobile phone app store (http://smokefree.gov/apps-quitstart). The group lead will open up the

floor to the participants to voice and discuss some of their barriers to smoking cessation and give

tips and support on how to help and achieve their quit plan.

END CLASS

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For our evaluation, we will use a Randomized Control Group Pretest-Posttest design. To recruit

subjects, we will use the Duval County Health Department as our population. DCHD services a

population of 800,000; a sample of 300 will be taken from their current clients. The clients will be given

a short 1 page questionnaire upon their visit to the health department and depending on if they are

smokers and wanting to attend the program, will be given the information and dates of the program.

Inclusion criteria for attending the programs would be for current smokers. With such a large population

and high prevalence of smoking in the area 300 subjects will be selected and randomly assigned, 150 will

be in the intervention group, and 150 will be in the control group. We will pretest both groups at the

beginning of the four introductory classes which will be held during the first month of the program and

will require the participants to only attend one. The following month starts the programs cessation and

support class. The intervention group will receive a 1 hour cessation and support class twice a month.

The class shall be led by a cessation specialist and 3 support cessation coaches. For the first 5 minutes of

the class the specialist will briefly go over risk of lung cancer and key in on smoking being the number

one risk factor. This will be repeated at the start of each class form here on out to hammer home to risk

factors associated with Lung cancer, to strive for the point of the cessation program and to help

accomplish our learner objective.

The next 10 minutes of class shall be spent with the cessation specialist trying to make the

program personal for the participants by going over “Reasons for quitting”. This shall include areas such

as:

Your health and Appearance:


will go down


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Your Lifestyle:


will go down






Your Loved Ones


will go down






The point is for the participants to make a list of all of the reasons they want to become smoke free and

keep it in a place where you will see it often, like their car or where they keep their cigarettes it’s there

to remind them why they want to quit. This information will be followed by the participants on the

P a g e | 22

power point presentation and will be done for only the first two classes in the second month of the

program (the first and the second cessation and support class). Thereafter the 10 minutes will be used

to expand more time for the support group portion of the class.

The next 10 minutes of class the cessation specialist will go over the cessation plan with the

participants. The participants will have a handout with the cessation plan on it. The plan is as follows.

Pick a quit date: Circle it on the calendar; it will remind you of your decision to quit.

Let loved one know your quitting: support is important and key to success

Remove reminders of smoking: remove, matches, lighters, ashtrays, clean car and home

Make a reason for quitting list: a reminder so when u feel an urge, look at it.

Identify triggers: Write down what makes u feel likes smoking, list a way to deal or avoid.

Coping strategies: nicotine replacement

Plan for Immediate support: Use the quit lines, or the Quit smoking apps, support groups, meds

Set up milestone reward: Treat yourself once you hit a milestone, 2 weeks or 1 month, buy

yourself a nice dinner or something you’ve been wanting.

This is the quit plan the program shall follow. Each Participant shall work on their quit plan on their

own outside of the class so when they come to the next class they have a plan, as they continue

through he program plans may need to be adjusted or tweaked this will be handled in the support

group at the end of the class.

The last 30 minutes of class (for the first two cessation and support classes only, thereafter it will

be 40 minutes starting with the third class) will be used to break the participants up in to smaller

P a g e | 23

group of equal numbers among the 3 cessation coaches and the 1 specialist. Each will conduct a

support group style meeting with their group of participants. Here they will discuss stressors,

triggers, and cravings that lead to wanting to smoke and slips. They will help with these areas by

teaching coping skills, problem solving skills, and medications to apply to counter these stressors

and triggers. The group lead will supply the free samples of nicotine replacement for the participants

if wanted and discuss their uses and the pros and cons of each. The group lead will introduce their

participants to the free mobile applications that can provide help and support in times of cravings or

needs. These applications are QuitSTART app, NCI QuitPal App, and QuitGuide app all found on your

mobile phone app store (http://smokefree.gov/apps-quitstart). The group lead will open up the

floor to the participants to voice and discuss some of their barriers to smoking cessation and give

tips and support on how to help and achieve their quit plan. The control group will receive the same

cessation and support class with one difference. The control group will not be offered nicotine

replacement samples. The post test will be conducted 3 months after program completion.

To evaluate the impact learner objective, “By the end of the Program 80% of participants will be

able to list three risk factors of lung cancer.”, participants will be asked to list risk factors of lung

cancer on the pretest, and we will compare it by asking them to list three risk factors of lung cancer

on the final day of the program on a questionnaire. An example of the question that will be asked:

“Please list three risk factors of lung cancer.” This data be collected and analyzed by the program

administrators

To evaluate the impact behavioral objective, “Three months after the programs, 20% of

participants will have quit smoking.”, participants will be asked if they currently are smoking and if

so how much on the pretest, and we will compare it to the answers given on the posttest. Examples

of the question that we will use to asses this are: “Are you currently smoking cigarettes?”, “How

P a g e | 24

long has it been since you completely stopped using cigarettes?”, “How much tobacco do you use

per day?”, “How many cigarettes /packs do you use per day?”, “Have you tried quitting smoking

again since the program ended?” This data will be collected by the program administrators and

analyzed by an outside statistician.

To evaluate the outcome objective, “Within five years after the program, Lung Cancer will

incidence will decrease by 10% in Duval county.”, we will compare Duval County lung cancer

mortality data on the DCHD website at the beginning of the program, with Duval County lung cancer

mortality data on the DCHD website five years after program completion. This data will be collected

and analyzed by the program administrators.

Time line

P a g e | 25

December 2013

Conduct needs assessment with Clay County Health Dept. population.

January 2014

Develop Intervention, goals, and objectives for intervention.

February 2014

Hire cessation specialist and support coaches, go over and train on outline of intervention.

March 2014

Begin sample selection from Duval County Health Dept. 300 Clients who currently smoke.

April 2014

Each week one Program Introduction Class (4 total), Pre-Testing will occur each week, subjects only have to attend one of the classes for the month and will be randomly assigned to the control group or experimental group and informed which date to attend the Cessation and support class starting next month.

May 2014

Cessation and Support classes begin, twice a month, one class for control group that will not be given the nicotine replacement intervention and one class for the experimental group that will include nicotine replacement intervention.

June 2014 – December 2014

Cessation and Support classes will run till the end of December whereupon the program and intervention will end. Impact evaluation for learner and process objectives will be tested at the

P a g e | 26

end of the last class.

March 2015

At the end of the month a post-test questionnaire will be mailed out to the 300 program participants so that our behavioral objectives can be evaluated.

Budget

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Personnel:

1 Cessation Specialist - $30 per hour 16 hours total + 480.00

3 Support Coaches - $15 per hour 16 hours total + 720.00

Program Materials

Design and printing of program materials + 5000.00

Design and support of program software +3000.00

Nicotine Replacement

Equate Nicotine Transdermal System – $25.98 +67,000.00

Misc Expenses

Office Supplies +500.00

Total 76,700.00

smoking cessation program

Documents