Trans-disciplinary Care: A New Approach to Improving the Effectiveness of Tobacco Use Interventions

Abstract

T use disorders devastate lives and financial well-being, and constitute one of the largest public health problems the world faces today. A main cause of avoidable illness and death, tobacco-related mortality rates lead to more than 435,000 deaths per year, in the United States alone1–3 with millions more affected by tobacco-related illnesses. Annually, nearly 96 billion dollars are lost to medical costs directly related to smoking.4 While smoking is the most prevalent form of tobacco use, all forms of tobacco use pose dangers to health. The well-being of entire communities, particularly underserved communities, is affected, making tobacco use one of the largest public challenges facing the health care system today. Tobacco use, like any addiction, is complex, affecting individuals, families, and communities in many ways. It is critical that tobacco use disorders be addressed in both micro (individual) interventions and macro (community-wide) initiatives with the challenges of working with underserved populations considered. Evidence suggests interventions which have been proven effective with the general population will work with underserved populations, if those interventions are made available. The key components of evidence-based tobacco use interventions center on dynamic system changes incorporating policy support and performance feedback mechanisms. Incorporating current developments in national standards surrounding the creation of medical homes and meaningful use of electronic health records, and reinforced with a trans-disciplinary approach, evidence-based smoking cessation practices can have an effect on tobacco use in underserved communities. One of the new ways to increase the effectiveness of tobacco interventions being explored is the utilization of trans-disciplinary teams, now being developed in health care organizations around the country. An evolution from inter-disciplinary care, transdisciplinary care is a multi-disciplinary team in which all members have expanded knowledge and training in the disciplines of other team members. In a transdisciplinary team model, all members of the team address tobacco use and reinforce goals, regardless of the main purpose of the visit. This shared reinforcement, along with the transmission