Stopping the Vapor of Death: Implementing a Vaping Cessation Protocol in an Emergency Department

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Introduction/Purpose: Vaping is a common and significant clinical problem among young adults. Vaping uses a device to heat nicotine extracted from tobacco (vape juice or e-liquid) to produce a vapor for inhaling. The perceived lack of adverse health effects and various enticing flavors has escalated the popularity of vaping. Vaping liquids contain nicotine, a dangerous and highly addictive chemical, and other toxic substances. Vaping is a significant public health problem and a significant risk for cardiovascular disease and cancer including head, neck, lung, and colorectal cancers. It is essential that health care providers identify, document, and treat every tobacco user seen in a healthcare setting to increase vaping cessation rates among young adults 19-25 years. This quality improvement project aimed to improve healthcare providers' utilization of the 5As model for smoking cessation (asking, advising, assessing, assisting, and arranging follow up), targeting patients 19-25 years (young adults) who self-identified as vaping, by implementing and evaluating the impact of a vaping cessation protocol in a suburban Emergency Department (ED). Methods: Identified behavior-vaping during triage and documented in the electronic medical record (EMR); pre-and post-provider education survey; 5A model for smoking cessation; number of patients that received counseling on vaping cessation. Results: Healthcare providers in the ED (n=11) went from 73% rarely talking to young adults about vaping cessation to 81% of the healthcare providers (n=7) utilizing the 5As to talk to young adults about vaping cessation in a 21-day period. Discussion: Vaping is a serious health threat to young adults. Before implementing this quality improvement project there was no standardized protocol in the ED for addressing vaping cessation in young adults. Through application of a standardized protocol the process was streamlined. By providing the healthcare providers in the ED with education on the harms of vaping and how to talk to young adults about vaping cessation, providers were given a specific protocol to employ. Utilization of the 5As for vaping cessation counselling increased the number of young adults who self-identified as vaping receiving vaping cessation counselling. This protocol has the potential to be implemented to all ages of ED patients that self-identify as vaping or smoking.

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Vaping, Nicotine, 5As, Cessation
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