Doctor of Nursing Practice (DNP) Projects

Provider Focused Process Improvement Project to Enhance Patient Participation in a Tobacco Smoking Cessation Program

William J. Sullivan


United States soldiers face the most heinous dangers on a daily basis while serving our country. Despite knowing the risks, they are courageous and willing warriors. They are equipped with training, knowledge, and equipment to combat these dangers. However, despite all the training, despite the equipment, and despite their courage, there is a danger that lurks beyond those associated with military service and it is tobacco smoking. Tobacco smoking is associated with life threatening and life limiting disease. The effects of tobacco smoking may take years to present which can provide a false sense of invincibility to the Veteran.

Tobacco smoking has declined among the general population. However, the same is not true among the military Veteran population. Reported estimates suggest that smoking is 40% higher among Veterans compared to the general population. The literature also suggests that smoking-related illnesses have been higher among patients in the Veterans Health Administration compared to the general population. Smoking tobacco presents a major risk factor for heart disease as well as chronic obstructive pulmonary disease. Smoking cessation is associated with reduction in prevalence of these diseases, decreased exacerbations, and reduced mortality.

The project design included a one group pre and post assessment inclusive of an education program related to the use of confidence rulers and a practice session. A parametric statistical analysis was completed with a paired t test based on data obtained from the pre and post assessments. Findings indicated a suggestion that the intervention was associated with an increase in the participants' perception of their ability to influence smoking cessation.