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Environmental Influences on Rehabilitation Outcomes: Tobacco Cessation & Other Toxic Exposures

Environmental Influences on Rehabilitation Outcomes: Tobacco Cessation & Other Toxic Exposures

Environmental Influences on Rehabilitation Outcomes: Tobacco Cessation & Other Toxic Exposures

This course includes
1:55:30 of Course Material (View)
Lifetime access after purchase
Certificate of completion

Welcome to Elective 2 of the Integrative Lifestyle Medicine Certificate

Environmental Influences on Rehabilitation Outcomes: Tobacco Cessation & Other Toxic Exposures



Substance abuse may yield a greater impact in rehabilitation as the single biggest preventable risk factor for disease, beyond that even of diet and physical activity. Of our patients who smoke, the World Health Organization reports that half of them will die. Smokers also impact those around them, with 1.2 million deaths attributed to second-hand smoke. 
According to research, smoking leads to suboptimal physical therapy treatment outcomes in all four physical therapy and rehabilitation practice areas: musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary health. This reinforces the need for the implementation and effective application of evidence-based smoking interventions within physical therapy and rehabilitation practice and education.

And yet, research also reveals that only a small minority of physical therapists employ, and physical therapy schools include, tobacco cessation counseling (TCC) education. The literature posits that TCC education is consistent with professional values espoused by physical therapists, which can be useful for occupational therapy as well, and this course will cover the public health guidelines for TCC, and also tackle other common substance abuse issues, including discussion of the risks and benefits of steroid injection practices in orthopaedic practice and a review of environmental toxins and how they impact our practice, outcomes, and health and functioning. 


Clinical Objectives

There are two parts to this course. The learning objectives for each part of the course are listed below.

In Part 1, you will learn:

  1. Describe the adverse impact of tobacco use and other substance abuse (including steroid injections).
  2. Describe the adverse impact of environmental pollutant exposure.
  3. List the major endocrine disruptors supported in the evidence base to cause adverse health effects.
  4. Summarize the 5 A’s approach for tobacco and other substance abuse cessation.
  5. Review the USPHS Tobacco Cessation Guidelines.
  6. Discuss basic interventions to assist tobacco and substance abuse cessation. 


In Part 2, you will learn:

  1. Discuss the importance of using a multidisciplinary team approach in tobacco and substance abuse cessation.
  2. Describe basic approaches to behavioral and pharmacology therapies in tobacco and substance abuse cessation.
  3. List resources available to help with cessation.
  4. Review the major diagnostic criteria for differential diagnosis of substance abuse disorders.
  5. Cite evidence-based screening tools for substance abuse.
  6. Summarize simple interventions for cessation assistance.
  7. List the parameters for when to refer to specialists. 


Who is this Course for?

Physiotherapists, occupational therapists, athletic trainers, and related professions


Please note: This course is a part of the Integrative Lifestyle Medicine Certificate by Dr. Ginger Garner. You can take this course as a stand-alone course. You can choose to take each module separately or purchase the entire course track. It is recommended to take all modules of the Integrative Lifestyle Medicine certificate in the order they are laid out in the course track. It is required to take all modules to receive your certificate. You are only eligible to receive CEUs if you take all modules. CEUs are not awarded for individual modules, but rather for completing the entire course certificate.

You can view the entire certificate program by clicking here.

The instructors
Dr. Ginger Garner

Dr. Ginger Garner PT, DPT, ATC/L is an active clinician, author, teacher, and longtime advocate for improving access to physical therapy services. She is the CEO of Living Well Institute which she founded in 2000 to teach therapists how to integrate Yoga and Lifestyle Medicine practices into clinical and health promotion practice. Board certified in Lifestyle Medicine (DipACLM) and a certified Professional Yoga Therapist (PYT), Ginger has spent 26 years designing best-evidence yoga-based physical therapy programs. Her private practice, EudeMOMia®, located in Greensboro NC, offers a unique model of virtual services and in-person care. Ginger is the author of Medical Therapeutic Yoga, slated for 4 foreign translations and currently published in English and Italian. As an international speaker and educator, she has presented at over 20 conferences worldwide and has taught in 6 continents across a range of topics impacting the pelvic girdle. Ginger is an active member of APTA, serving as the Legislative Chair for APTA NC Chapter.

Ginger lives in Greensboro, NC with her partner, 3 sons, and their rescue pup, Scout Finch. Visit Ginger at and

Course Material included in this course
  • Environmental Elective 1
  • Handouts
  • Smoking & Vaping
  • Corticosteroid Injections
  • Other Common Substance Abuses
  • Environmental Health and You
  • Toxins
  • Guidelines & Interventions
  • Feedback
  • Environmental Elective 2
  • Handouts
  • Team Approach
  • Behavioral & Pharmacology Therapies
  • Resources & Diagnostic Criterea
  • Screening
  • Intervention & Referral
  • Program Review
  • Feedback
  • Environmental Case Study
  • Handouts
  • Smoking Cessation Case Study
  • Environ POST-TEST
  • Feedback
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