Expanding the Reach of Tobacco Cessation Strategies
By Connie Miyao, RN, BSN, ONA Nursing Practice Consultant
Nurses have a key role to play in influencing the health of patients. Whether working in a hospital or in the community, nurses are ideally placed to encourage smokers to give up smoking. Even the most basic intervention by a health professional can have a profound effect, encouraging a smoker to stop or to seek help in stopping. Many smokers stop as a result of a health problem, where contact with a nurses puts the nurse in the ideal position to encourage and support smoking cessation. Nurses will be familiar with patients’ past experiences and are able to advise on the smoking cessation services and treatments available.
The challenge will be to incorporate smoking cessation interventions as part of standard nursing practice so all patients are asked about their tobacco use and have an opportunity to receive advice on how to quit along with reinforcement and follow up. Nicotine replacement therapy has been shown to improve quit rates when used in conjunction with counseling for behavioral change and should be considered an important adjunct, but not a replacement, for nursing interventions.
Use of evidence-based strategies is an expectation of good nursing care. To promote successful cessation attempts for patients who smoke, clinicians should follow the five A’s:
- Ask about tobacco use at every visit.
- Advise tobacco users to quit.
- Assess readiness to quit.
- Assist tobacco users with a quit plan.
- Arrange follow-up visits.
There are ways to broaden the reach of nursing and continue to impact this priority public health issue. Nursing curricula must include information about the health effects of tobacco use, exposure to secondhand smoke, prevention of tobacco use and science-based strategies for tobacco dependence treatment, as well as clinical practice opportunities, to ensure that all nurses are competent in tobacco control and cessation interventions. Practicing nurses need to be provided with educational workshops and professional education regarding tobacco control. All nursing students and practicing nurses need training to be competent to deliver tobacco control interventions. Nurses in public health departments need training to engage in comprehensive tobacco use prevention and control.
Nursing research on tobacco use, prevention, cessation interventions and reduction of exposure to secondhand smoke must be expanded. Dollars for research funding need to increase and be dedicated to tobacco-related illnesses and their treatment.
A start to this would be the appropriate use of Tobacco Master Settlement Agreement (TMSA) funds for their original intent, tobacco prevention, cessation, and health related costs of tobacco. ONA believes targeted investments in prevention, cessation, physical education and school based health centers will help keep kids healthy and off tobacco and this will improve public health and will decrease costs to the health care system.