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Journal of Nursing

A Shout Out to New Grads: Smoking Cessation Education Today and Everyday

Are there any good things about tobacco use? Is there even one good thing about tobacco use? Everyone knows tobacco use of all kinds is deadly. , by Nancy J Smith MSN RN at the University of Hartford [email protected]

Tags: tobacco

Are there any good things about tobacco use? Is there even one good thing about tobacco use? Everyone knows tobacco use of all kinds is deadly. A large national pharmacy chain has recently announced that it will stop selling cigarettes in stores so as to be viewed as a health promotion company. Tobacco use has been officially on the health care providers list of terribleness for the past 50 years. In 1964, the Surgeon General Luther L. Terry, MD released the first report that conclusively connected cigarette smoking and lung cancer. According to a 2012 report from the Center for Disease Control and Prevention (CDC), 45 million American adults light-up, chew or snuff tobacco daily. It kills about 438,000 each year and causes more than 8 million people to live with serious illness such as chronic obstructive pulmonary disease (COPD), directly related to smoking and yet tobacco use continues. It is big business for the tobacco companies, a 2010 report from the Tobacco Atlas showed the combined profits of the six leading tobacco companies was 35 billion dollars, worldwide. Tobacco will never be eliminated, but can be countered with tobacco cessation education from nurses.

Adolescent smoking rates are creeping up after decades of decline. A 2011 report from US Department of Health & Human Services, Office of Adolescent Health says that 600,000 middle school students and three million high school students currently smoke, which is a steady increase since 2005. An increase has been seen, as well, for the rates of young adults ages 18 – 35, who use tobacco, according to information published in the Journal of Environmental Public Health. The harmful effect of tobacco as well as smoking cessation education needs to re-enter the frontlines of patient education at a yearly health exam, community service announcements and reminders posted at the high school health class. To that end, tobacco use needs to be un-glamorized and de -glorified by Hollywood and politicians,( President Obama admits to being a smoker and has attempted to quit several times.).

To exert health promotion influence against the tobacco industry, all nurses need to renew efforts–to help one patient at a time to cease tobacco dependence. As a nurse transitions from student to newly licensed practitioner, the tobacco cessation education that was taught in the classroom must be incorporated and expanded as a part of the daily nurse practice. Resources are abundant online for example Registered Nurses of Ontario Association (RNAO) Best practice Guideline (BPG): Integrating Smoking Cessation into Daily Nursing Practice. One simple useful tool put forth in this BPG is The 4As that every nurse can utilize with all patients. Ask if the patient uses tobacco, advise the patient to quit using tobacco, assist the patient with learning about various options available to aid the quit attempt and arrange for the method(s) chosen. The 4As straightforward statements as well as other tools such as social media support groups through Facebook, telephone quitlines and pharmacological interventions of transdermal patches or nicorette gum can be applied to a myriad of nursing practices, for instance community flu shot clinics, peri-operative nurse assessments, high school nurses office or homecare visits. These methods can be explained with didactic tobacco cessation education, by nursing faculty and utilized in clinical learning with pre-licensure undergraduate nursing students to help develop excellence in nurse practice. As stated in the BPG, theses interventions take three minutes or less; minimalist intervention, but have a lasting impact.

There may be overlying issues with the nurse who smokes cigarettes, cigars, hookah or pipes. It may evoke a feeling that she/he has no right to address the problem with a patient while struggling with the habit themselves but research from Tobaccofreenurses.org shows that patients are willing to listen to those nurses. There is a feeling of empathy in the struggle, in that the health care professional struggles as well and may also be trying to eliminate the tobacco habit from her or his own life. The nurse understands the challenge while advocating for the client. There are commonalities in the smoking cessation education; research has documented that smoking cessation is a process. According to statistics in the BPG and from the CDC nicotine dependence is increasingly recognized as a chronice relapsing condition. Many smokers have to attempt to quit many times prior to achieving success. Each attempt is one step closer to achieving a tobacco free life. To have the nurse reiterate the suggestion of tobacco cessation may be exactly the one sway that the patient needs to attempt and succeed to quit the tobacco dependence.

Patient advocacy is at the core of nurse practice. To advocate to and for the patient about how to improve one’s own health is a primary and life affirming tenet of nurse practice. Each student nurse, new graduate nurse as well as seasoned nurse must renew the value of tobacco cessation education and utilize it with renewed vigor for each and every patient for whom care is provided, starting today.

References
Centers for Disease Control and Prevention website. (n.d.).
Rath, J. M., Villanti, A. C., Vallone, D. M., & Abrams, D. B. (2012, May 14, 2012). Patterns of tobacco use and dual use in US young adults: The missing link between youth prevention and adult cessation . Journal of Environmental and Public Health
Registered Nurses Association of Ontario. (2007). Best Practice Guideline: Integrating Smoking Cessation into Daily Nursing Practice. Toronto, Canada
The Tobacco Atlas website. (n.d.)

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