There is a need for program evaluations associated with educating healthcare professionals about the treatment of patients who use tobacco. The purpose of this study was to evaluate a Tobacco Treatment Specialist Training program with a pre-test and post-test (provided six months after the program) to determine if participants-maintained knowledge and practices to help patients with tobacco cessation in a mixed-model analysis. A pre-test survey was administered to attendees of a three-day tobacco treatment training continuing education certification program. After 6 months, the attendees were provided a post-test survey with open-ended and Likert-style questions. There were 98 participants who completed the pre-test and 16 who completed the post-test. Responses to the knowledge, confidence, and skills post-test indicated that there was significant improvement and maintenance at the six-month post-test. For example, knowledge improved from a mean of 61.1% (SD: 25.6%) to a mean of 87.9% (SD: 14.4%); medians of 66.7% and 77.7%, respectively, p < 0.001. The in-depth, intensive, three-day TTS training program had a lasting impact. Providers reported greater commitment to helping their patients quit and maintain tobacco cessation habits.

Tobacco Use Disorder (TUD) is a chronic, relapsing disease and the leading cause of preventable disease and death. Research forecasts one billion people will die due to TUD during the 21st century. 1 Smoking is associated with cancer, heart disease, stroke, lung diseases, periodontitis, caries, oral, and esophageal cancer. 2 Secondhand smoke is associated with periodontitis, stroke, lung cancer, coronary heart disease and in children increasing sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, and delayed lung growth. 3 Tobacco use in youth is associated with negative impacts on attention, learning, mood, and impulse control. 4 Client's successful tobacco cessation is related to a reduction in depression, anxiety, stress, and lessen the likelihood of relapse to alcohol and other substances. 5,6 Seventy percent of smokers who present for tobacco cessation treatment do not receive the evidence-based pharmacotherapy and counseling that can double abstinence rates. 7 Health-care providers report the lack of experience or expertise as a barrier to effectively treating TUD. 8 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

The purpose of this research is to examine the association between nicotine dependence (yes, no) and hip replacement (yes, no) among people with type 2 diabetes mellitus (T2DM). Data were obtained through the TRINET-X data depository of 18 years or older patients with T2DM and nicotine dependence history. Then, the incidence of hip replacement surgery was determined. Propensity score matching (PSM) was used to determine the risk of hip replacement surgery. After PSM, the risk ratio of hip replacement surgery among people with T2DM was 1.45 (95% confidence interval: 1.45, 1.57; p < 0.0001) for those who had nicotine dependence versus those who did not. Nicotine dependence among people with T2DM was identified as a risk factor for future hip replacement need. Patients who have nicotine dependence should be cautioned about this potential risk.