Tobacco use, in all its forms, is the number one cause of preventable illness, disability, and premature death around the world. The World Health Organization has identified it as a global epidemic. Action on Smoking & Health (ASH) has correlated it with more than 50 illnesses and 20 fatal conditions, including cancer, cardiovascular disease, stroke, and respiratory diseases. According to ASH, tobacco will kill one billion people in the 21st century if nothing is done to limit its use.
In the U.S., despite organized efforts to reduce tobacco use, 40 million adults (16.8 percent of the population) were still smoking cigarettes by 2014. And some of these smokers are nurses. Despite a nationwide trend toward smoke-free hospitals, a 2011 study found that seven percent of RNs and a whopping 25 percent of LPNs still smoke. Perhaps the worst part of this is that nurses who smoke perceive themselves as not being a credible role model to help their patients stop smoking—meaning opportunities to advocate for a healthier lifestyle are being lost. An initiative known as Tobacco Free Nurses (TFN) is working to change that. TFN would like to not only eliminate smoking among nurses, but equip nurses to assist their patients and colleagues to quit smoking as well.
As frontline caregivers, nurses have frequent contact with patients, in both community and healthcare settings. As a nurse, you have most likely seen some of your patients suffer from symptoms and diseases related to smoking. According to the ANA, “If the 3.4 million working nurses in the U.S. each helped one person per year quit smoking, nurses could greatly increase the U.S. quit rate.” This is patient advocacy at its highest level. It is a chance to advocate not only for the individual patient, but to improve the public health of the entire nation.
The Tobacco Free Nurses initiative began in 2003, with funding from the Robert Wood Johnson Foundation. It was the first national program to focus on reducing tobacco use by:
- giving nurse clinicians the education and resources they need to function as smoking cessation interventionists
- assisting the smoking cessation efforts of nurses and nursing students
- positioning nurses as leaders and advocates for a smoke-free society
Studies show that nurses can make a real difference in smoking cessation, acting as coaches and advisors to patients in hospitals, cardiac/pulmonary practices, obstetrics practices, and rehabilitation facilities. Commentary in the Journal of Cardiopulmonary Rehabilitation & Prevention noted that nurse-led interventions for smoking cessation could increase success rates by 50 percent. Now, we need to increase the number of nurses who are providing this type of support to their patients. A survey of 4,000 nurses found that those familiar with the TFN initiative were significantly more likely to offer smoking cessation interventions to their patients.
Where do you stand? Can you speak candidly to your patients about the health impacts of tobacco and the benefits of quitting? Can you explain to an expecting mom how tobacco use affects her unborn child? Are you ready to suggest strategies for quitting and able to help patients overcome the most common barriers to smoking cessation? When patients ask you for information about nicotine patches or the safety of e-cigarettes, do you know where to direct them?
If you’re not already aware of the resources offered online, now may be the time to review them and find ways to become an advocate for your patients and a smoke-free nation. The Agency for Healthcare Research & Quality (AHRQ) has online guidelines for clinicians to help smokers quit. And the TFN nurses website has a comprehensive list of resources, many of which relate to specific patient populations, like teenagers or pregnant women.
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