Alexander

Case Description: 38-year-old male with persistent cough
Alexander is a 38-year-old man who presents to his primary care physician with a persistent cough. The interview leads to a discussion about smoking cessation and the process of change.

Cultural Competency
This case deals with the following:


 * 1) Discussing topics that are often difficult and personal to the patient
 * 2) How to approach an uncomfortable subject for both patient and physician.
 * 3) Providing education in a nonthreatening manner.
 * 4) Getting past education resistance
 * 5) Learning how to approach and deal with the subject of smoking cessation.

Links to Discussion

 * Smoking Cessation Options

Recommended Resources
http://www.lungusa.org/site/apps/s/content.asp?c=dvLUK9O0E&b=34706&ct=66721
 * Below is a link to some interesting facts about teen smoking from the American Lung Association:

http://www.epa.gov/asthma/shs.html
 * Link to information on Second Hand Smoke

http://www.ahrq.gov/consumer/tobacco/quits.htm
 * Evidence based resource on quitting smoking

http://www.californiachronicle.com/articles/viewArticle.asp?articleID=39943
 * Starting in 2008, California will outlaw smoking in all vehicles containing children under 18 years old to limit kid’s exposure to second hand smoke.



Links for smoking education topics:

Specifically the section: "Finally, cultural competency for tobacco intervention training has not been developed to any significant degree in US medical schools, despite the high prevalence of tobacco use among many minority populations5 and the finding that tobacco intervention is best accomplished among these groups through culturally relevant approaches."
 * 1) Why quit: A Source on helping your patients find reasons to stop smoking www.whyquit.com
 * 2) AAFP Ask and Act power point presentation: excellent resource on providing clinicians with information about approaching smoking cessation among their patients. http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/pub_health/askact/ppt-physicians.Par.0001.File.tmp/askandact-presentation-clinicians.ppt
 * 3) Tobacco Intervention Training,Current Efforts and Gaps in US Medical Schools  John G. Spangler, MD, MPH, et.al. JAMA. 2002;288:1102-1109.

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