PhysICAL THERAPISTS
Physical therapists are in a special position to promote the health of their clients, especially post-surgery or injury, and thus significantly reduce smoking among their clients.
Physical therapists could help a large number of clients quit smoking by:1
- Taking time to advise them about quitting
- Helping them plan a date to quit
- Giving them self-help materials
- Following up with motivation and progress toward smoking cessation
- Referring some to smoking cessation programs
Cigarette smoking is the leading avoidable cause of mortality in the U.S., accounting for 400,000 deaths each year. Physical therapists can play a major role in a client's life regarding smoking cessation.
Physical therapists working with postoperative clients should be supportive of cessation efforts. Clients may be especially tempted to engage in smoking after surgery, and it may be a common belief that smoking reduces postoperative nausea and vomiting (PONV). However, this phenomenon is unexplained and may be psychological, as recent research indicates that reduction in PONV after smoking is not related to levels of preoperative exhalation of carbon dioxide.2
Tobacco use is a risk factor for certain complications after spinal injury and surgery, including respiratory dysfunction and thromboembolic problems.3, 4
Current or previous smoking may be associated with poorer long-term outcomes of severe lower-limb trauma.5
Health promotion may be considered an important aspect of physical therapy. Based on a 2004 study conducted in three states (California, Tennessee, and New York), physical therapists may be practicing health promotion, particularly in the area of smoking cessation, at rates far below goals of Healthy People 2010. This study also found that feelings of self-efficacy (confidence) to perform health promotion was the strongest predictor of such behavior among physical therapists.6
Physical therapists may be in a prime position to support tobacco use cessation and prevention among their clients, and it is important that these professionals have the information, skills, and confidence needed to do so.
Helpful Links
The American Physical Therapy Association's Advocacy webpage includes Women's Initiatives related to lung cancer and smoking.
The American Physical Therapy Association of Maryland, Inc.
A private sector panel of experts developed a How-To Guide for Clinicians which provides information on first-line pharmacologic therapies and counseling to help clients quit using tobacco.
The MDQuit staff appreciates any suggested links that may help physical therapists seeking information about tobacco, specific to their field.
Fax to Assist
See Fax to Assist for more information on our Fax Referral Program.
References:
1 Cummings, S.R., et al. (1989). Smoking counseling and preventive medicine. A survey of internists in private practices and a health maintenance organization. Archives of Internal Medicine, 149, 345-9.
2 Whalen, F., Sprung, J., Burkle, C. M., Schroeder, D. R., & Warner, D. O. (2006). Recent smoking behavior and postoperative nausea and vomiting. Anesthesia & Analgesia, 103, 70-75.
3 Platzer, P., Thalhammer, G., Jaindl, M., Obradovic, A., Benesch, T., Vecsei, V., et al. (2006). Thromboembolic complications after spinal surgery in trauma patients. Acta Orthopaedica, 77, 755-760.
4 Brown, R., DiMarco, A. F., Hoit, J. D., & Garshick, E. (2006). Respiratory dysfunction and management in spinal cord injury. Respiratory Care, 51, 853-870.
5 MacKenzie, E. J., Bosse, M. J., Pollak, A. N., Webb, L. X., Swiontkowski, M. F., Kellam, J. F. et al. (2005). Long-term persistence of disability following severe lower-limb trauma: Results of a seven-year follow-up. The Journal of Bone and Joint Surgery: American Volume, 87, 1801-1809.
6 Rea, B. L., Marshak, H. H., Neish, C., & Nicceta, D. (2004). The Role of Health Promotion in Physical Therapy in California, New York, and Tennessee. Physical Therapy, 84, 510-523.
