Keewaytinook Okimakanak Health’s Smoking Cessation Project

By Rick Garrick Feb. 2008

Keewaytinook Okimakanak Health is developing a new Smoking Cessation pilot project in partnership with the Northern Ontario School of Medicine.

"We are trying to reduce the number of smokers in the community," says Robert Thomas, KO Health director. "We also want to come up with ways on how we can intervene, especially with the youth that are smoking at a very early age."

One of the main goals of the pilot project, scheduled to run from Feb. 1 to March 31, is to create an awareness among youth of the serious consequences of smoking. "Hopefully, we can make an impact on the younger generation," Thomas says. "With the rise in cancer in the Aboriginal community, this is one of the ways we can prevent cancer."

A project manager and five community coordinators have been hired to deliver the pilot project to the five KO communities of Deer Lake, Fort Severn, Keewaywin, North Spirit Lake and Poplar Hill, with funding provided by the First Nations Inuit Health Branch. Deer Lake community coordinator Joyce Meekis has been targeting the work places in her community, such as the Northern store, the Nursing Station and the health office, as well as doing home visits with the Elders.

"The Elders I visit have a lot of things to say about the Tobacco Control Strategy," Meekis says in an e-mail message. "They want more awareness on tobacco issues, and they want the band to do more to try to get message to young people about the dangers of smoking." Patricia Hunter, KO Health's assistant health director, explains that the pilot project builds on KO Health's best practices developed during the three-year First Nation Youth Tobacco Control Project which ended in 2006.

"It will help people to understand the impact of what smoking and second-hand smoke does to their health," Hunter says. Meekis adds that the Elders in her community want people to be more aware that smoking causes many health problems for babies and the younger ones, such as asthma, ear infections and other health problems. A couple of the Elders are also interested in talking to children at the schools in conjunction with the Smoking Cessation staff about the effects on smoking and how dangerous it is to one's health.

"Another target group we have is the patients who go out to urban settings to access health care," Thomas says. "While they are in care, we want to provide them with assistance on how to quit smoking." Once the patients return to the community, the pilot project's aim is to provide support to those patients to encourage them to successfully quit smoking.

"We are delivering this great smoking cessation program through the partnership of the KO communities, FNIHB, NOSM, KO Telehealth and KORI," says Franz Siebel, Keewaytinook Okimakanak Research Institute researcher. "The goal is to provide some continuity of care for community members who have been hospitalized as part of the program. We are working in partnership with NOSM researcher Dr. Patricia Smith, who is renowned for her smoking cessation research and evaluation."

Smith is currently working with hospitals and long-term care homes in northwestern Ontario to implement tobacco cessation clinical practice guidelines, with hospitals in Michigan to implement hospital-based smoking cessation programs, and with graduate students in the Masters of Public Health Program at Lakehead University to determine the types of tobacco cessation services currently being provided by healthcare providers in Ontario, including those working in First Nations nursing stations in northern Ontario.

"With KO, the whole idea is to provide continuity of care from the hospital back to the community," Smith says, explaining that the hospitals have not been providing support for those who have quit smoking while in hospital after they return back to their home First Nation. "After they leave the hospital, how do you provide continued support."

Smith says the goal is to ask those returning back home if they would like the assistance of a coach to help them quit smoking. "For those who say yes, the coach will assist them," Smith says, noting that the community coordinators will be acting as the coaches. The coach will provide them with an initial one-hour session, followed by another session two days later, then another five days later, and then once a week for two more weeks.

"As part of the study, we will find out if they have quit smoking or cut down," Smith says. "We will be able to see if this is a good approach."

Smith adds that the project will also involve four education sessions delivered by NOSM family medicine resident Dr. Teegan Trochimchuk over KO Telehealth's videoconference network, on smoking and diabetes, smoking and breast cancer, smoking and pregnancy, and smoking and the effects quitting has on medical treatments.

"If you quit smoking, your risk for complications in surgery is less," Smith says. "When you're smoking, you're cutting back on the oxygen delivered to your body." The KO Research Institute was created by the Chiefs to encourage this kind of collaborative work says Brian Walmark, KORI's research director.

"This Smoking Cessation Project focuses on an identified community, the challenges of remaining smoke-free after leaving hospital and returning to your home community," Walmark says. "KORI has created a team of community members, KO staffers and world class researchers such as Patricia Smith of NOSM to develop a plan to address the challenge and document best practices and lessons learned."

MacDowell Lake band member Verlin James was hired as project manager, and he is looking forward to working with the community coordinators to coach the returning patients and provide information to youth in the communities about the dangers of smoking.

"We will be providing follow-up care for people returning to the community who have quit smoking while in the hospital," James says. Workshops and a quit smoking contest are also planned for each community, and four education and lecture-based videoconferences are in the works. Online training sessions will be provided through the Ontario Tobacco Research Unit, followed by one or two community training sessions delivered by Dr. Smith and the community coordinators. "Next week we will be doing the first community workshop," James says. "The videoconference workshop will be an orientation session to introduce myself, the community coordinators and Dr. Smith. It will be held in Thunder Bay, Deer Lake, Fort Severn and Keewaywin."

James explains that while encouraging people to continue not smoking is important, he feels that his primary goal is to prevent youth from taking up smoking in the first place"My primary interest is in that intervention phase," he says. "It's more important to intervene with the children while they're at a more impressionable stage."

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