Date of Award

Spring 5-27-2017

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Kathy James, DNSc, APRN, FAAN

Second Advisor

Juliana Gabbard, MSN, FNP


Tobacco smoking is the number one cause of preventable death in the US. It increases risk for cardiovascular and respiratory disease, diabetes, and many types of cancer. When contrasted with nonsmoking employees, smokers have a greater amount of lost productivity, as well as cost of health and life insurance claims due to illness. The purpose of this evidence-based project was to identify current smokers and monitor the consistency of their progression through the 5 A’s framework within an employee health clinic. Data was collected over two years and 600 charts were reviewed. After the data was analyzed, it was estimated that 8% of employees smoke and that both asking and advising patients to quit smoking is being completed reliably. However, improvement in the assess, assist, and arrange categories of the 5 A’s is needed. Although utilization of each of the 5 A’s steps is needed for the program’s success, future focus on improving arrange utilization by the Nurse Practitioner (NP) will allow for repeated review of each smoker’s cessation progress and barriers.