Writer’s choice

Are American Indians who require tobacco cessation techniques at a higher risk of lung disease than white Americans who use e-cigarettes for a year?

Patient Population

A PICOT is a mnemonic for the critical components of a well-crafted clinical inquiry that is pertinent to a patient’s condition at present and is framed in such a manner that a response may very well be obtained. The importance of a patient population stems from the fact that patient preferences vary from those obtained from the broader community [Ludwig et al., 2021]. It also aids in the focus of study when there are specific demographic groupings of interest. The American Indians are the patient population that I will be using. They have the most significant number of smokers of any race or ethnic group [American Lung Association, 2020b]. The Whites are the other patient population that is of importance. This is because 72 percent of whites are more inclined to keep using e-cigarettes [Webb Hooper &Kolar, 2016].


Tobacco cessation strategies. This is because the consequences of smoking are harmful to one’s health. Smoking cessation approaches include stopping without help, such as cold turkey or slowing down, and eventually quitting pharmaceuticals such as Nicotine Replacement Therapy [NRT] or varenicline, and cognitive behavioral therapy [Patel et al., 2016].

Comparison Intervention

The use of e-cigarettes as a tobacco-free alternative will be used as the comparison intervention to which the tobacco cessation intervention will be compared. E-cigarettes are becoming increasingly popular among smokers, with some viewing them as a less hazardous replacement for tobacco and others similarly using them to Nicotine Replacement Therapy to try to wean themselves off nicotine entirely [Institute for Quality and Efficiency in Health Care, 2017]. Unfortunately, there is not enough research done to determine how successful they are as a comparison intervention. Nurses and nurse practitioners can integrate screenings and guidance in regular preventative care; however, they are the least confident presenting patients with e-cigarette information [Prochnow, 2017]. Providing more information on e-cigarettes as a comparison intervention will give nurses the confidence to address it with the patients.


To observe the emergence of lung diseases as the outcome. Tobacco packaging features warning statements about the harmful effects of smoking, notably lung cancer. It indicates that smokers are already aware that smoking puts them at risk for lung disease. American Lung Association has discovered that acetaldehyde, a substance generated by e-cigarettes, can induce lung disease [American Lung Association, 2020a].

Time Frame

The research project has a one-year timeframe. An entire year is neither too long nor too short. Twelve months is sufficient time to obtain fairly precise results.




How might you go about replicating this approach in your institution or organization?



  1. How your population matches the populations in your research articles.
  2. The intervention you would implement
  3. Define baseline data collection sources [EMR, datasets, etc], method, and measures.
  4. Expected outcome [Include a specific plan of how you will measure/evaluate your change in practice: Specifically, Who, What, When, Where, and How]. 

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