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This chapter will overview the pathophysiology of the negative health effects of various tobacco products including cigarettes, hookah, electronic nicotine delivery systems (ENDS), and smokeless tobacco

Yet these products are often advertised to Native populations, exploiting their culture in the process

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Nursing Problem Priorities The following are the nursing priorities for patients with substance abuse: Ensure safety and monitor for withdrawal symptoms Provide education on substance abuse and its effects Assist in developing coping skills and relapse prevention strategies Facilitate access to appropriate treatment programs and resources Support the patients physical and emotional well-being Address any co-occurring mental health issues Encourage participation in support groups or counseling Nursing Assessment Assess for the following subjective and objective data: Physical signs such as dilated or constricted pupils, bloodshot eyes, slurred speech, or unsteady gait Behavioral changes, such as mood swings, irritability, changes in sleep patterns, or decreased motivation or productivity Social and occupational dysfunction, as observed through poor work or school performance, strained relationships, or isolation from social activities Observable signs of intoxication or withdrawal, including tremors, sweating, restlessness, or agitation Neglecting personal hygiene or a decline in grooming habits Strained or damaged relationships with loved ones due to substance use Elevated liver enzymes or positive drug screenings Reports from family members, friends, or other caregivers regarding the patients substance use or related behaviors

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