The Role of Physical Therapists in Smoking Cessation: Opportunities for Improving Treatment Outcomes

Abstract

Tobacco use constitutes one of the greatest threats to public health worldwide. As a preventable cause of mortality and chronic disease, tobacco use in the United States results in an estimated 443,000 deaths each year through both direct exposure and secondhand smoke.1 An additional 8,600,000 people across the nation have chronic illness due to smoking.1 As physical therapists, we must realize that tobacco use affects all areas of our practice, including cardiovascular, musculoskeletal, neurological, and integumentary health throughout the life span. In order to provide optimal care for the clients we serve, it is essential for physical therapists to screen for tobacco use and incorporate cessation strategies as part of our interventions.2 There is a substantial unmet demand and opportunity for our profession to promote tobacco cessation.2 Despite evidence that links successful cessation to counseling by health care providers, fewer than 40% of insured adults report receiving such advice.3 In addition, receiving advice from 2 or more health care practitioners more than doubles the odds of successful cessation,4 further supporting the need for physical therapists and physical therapist assistants to contribute our skills and expertise as part of the interdisciplinary health care team. Successful cessation efforts have been demonstrated by other health care professionals, including physicians, dentists, dental hygienists, nurses, and pharmacists, and are an important component of preventive medicine and population health.5 According to the US Medical Expenditure Panel Survey, in 2007, physical therapists conducted a total of 88 million ambulatory visits for approximately 9 million adults aged 18 years and over.6 The number of visits (an average of 9.6 per patient, per episode)6 and nature of our interactions, which include extended, personalized, one-on-one care, present a unique opportunity for physical therapists and physical therapist assistants to provide support for …