UICC Tobacco Control Fact Sheet No. 18

Enhancing the Nurses' Role in Tobacco Control

Increase nurses' involvement in tobacco control policies

As the largest group of health professionals, nurses can make an important contribution to global efforts to eliminate tobacco. Nurses can use their influence as health professionals in tobacco control efforts for a smoke-free society. Because attitudes toward tobacco use and decisions to smoke begin during childhood, nurses must focus on early childhood tobacco prevention.

• Increase the involvement and visibility of international nursing efforts in tobacco control through participation in the UICC Tobacco and Cancer Programme and collaboration with other anti-tobacco programmes and agencies.
• Increase nursing presentations and nursing attendance in tobacco control workshops and symposia.
• Encourage the development of an international group for "Nurses against Tobacco" to coordinate and maximize nursing efforts.
• Promote, institute, and publicize anti-tobacco policies in professional nursing organizations.
• Encourage community involvement of nurses in increasing public awareness and local tobacco policies to promote a smoke-free environment.
• Focus anti-tobacco activity on groups at highest risk: adolescents, the socio-economically disadvantaged, and women.

Nursing education and tobacco control

Nursing students must be educated about tobacco as the number one cause of preventable death and disability, and be empowered to intervene with those at risk from nicotine dependence, or those exposed to second-hand smoke. Practising nurses may not be adequately prepared to offer assistance and may require additional education.

• Develop and/or expand existing tobacco control curricula for nursing education.
• Encourage learning opportunities for nursing students that will reinforce their abilities to provide tobacco prevention education, assess smoking status, support smoking cessation, and relapse prevention.
• Incorporate and increase the number of questions about tobacco control in examinations for entry into practice.
• Provide postgraduate courses about tobacco control for practising nurses.

Nursing practice

Many smokers do not receive assistance with smoking cessation as part of routine health care. Studies have supported the critical role of the nurses in cost effective smoking cessation programmes. Smokers of all ages can benefit from smoking cessation.

• Standardize the expectations for assessment of tobacco use at every patient contact, documentation of smoking status, and assessment of the motivation to quit of smokers by all professional nurses.
• Encourage the involvement of nurses in multidisciplinary tobacco prevention, cessation, and relapse prevention programmes.
• Identify, utilize, and modify existing resources for tobacco control for use in nursing practice in different countries and with different populations.

Nurses' smoking habits

While smoking among nurses is declining in some countries, including the U.S.A., this continues to be a serious problem for many countries.

• Encourage nurses to become anti-smoking role models for health.
• Provide support for cessation attempts by nurses.
• Maintain a smoke-free workplace.

Nursing research

Tobacco-related research by nurses may contribute an important perspective to understanding smoking behaviours among patients during and after treatment.

• Target requests for proposals and increase funding for tobacco-related nursing research.
• Enhance inclusion of nurses in multidisciplinary research.
• Encourage international nursing research collaboration.
• Disseminate findings of nursing and other tobacco-related research for clinical utilization in international journals.

International collaboration

Encourage international collaboration in tobacco-related nursing activities.

• Facilitate consultation by nurse experts in tobacco control.
• Utilize international communication systems (such as GLOBALink) to facilitate networking.
• Explore funding opportunities to increase nurses' attendance at international conferences.

Acknowledgement

This fact sheet has been prepared for the UICC by Linda Sarne, RN, DNSc, of the Oncology Nursing Society, USA.

References

Adriaanse, H., Van Reek, J., Zandbelt, L., and Evers, G. (1991) "Nurses's smoking worldwide: a review of 73 surveys on nurses' tobacco consumption in 21 countries in the period 1959 - 1988", International Journal of Nurses Study, 28:362-375.

Clark, J.M., Haverty, S., and Kendall, S. (1990) "Helping people to stop smoking: a study of the nurse's role", Journal of Advanced Nursing,
16:357-363.

Elders, M.J., Perry, C.L., Eriksen, M.P. and Giovino, G.A. (1994) "The report of the Surgeon General: preventing tobacco use among young people", American Journal of Public Health. 84:543-547.

Fiore, M.C. (1991) "The new vital sign: assessing and documenting smoking status", Journal of the
American Medical Association, 266:3183-3184.

Hollis, J.F., Lichtenstein, E., Mount, K., Bogt, T.M., and Stevens, V.J. (1994) "Nurse-assisted smoking counselling in medical settings: minimizing the demands on physicians", Preventive Medicine, 20:497-507.

Lazenbatt, A. and McEwan, A. (1991) "An evaluation of the Ulster Cancer Foundation's nurses and smoking package and its impact on student nurses", Journal of Advanced Nursing, 16:1428-1438.

Padula, C.A. (1992) "Nurses and smoking: review and implications", Journal of Professional Nursing, 8: 120-132.

Nelson, D.E., Giovino, G.A., Emont, S.L., Brackbill, R., Cameron, L.L., Peddicord, M.S., and Mowery, P.D. (1994) "Trends in Cigarette smoking among U.S. physicians and nurses", Journal of the American Medical Association, 271:1273-1274.

Nett, L.M, & Obrigewitch, R. (1993) "Nicotine dependency treatment: a role for the nurse practitioner", Nurse Practitioner Forum, 4:37-42.

Rose, M. (1991) "Intervention strategies for smoking cessation: the role of oncology nursing". Cancer Nursing, 14:225-231.

Rienzo, P.G. (1993) Nursing Care of the Person Who Smokes. New York: Springer Publishing.

Taylor, C.B., Houston-Miller, N., Killen, J.D., and DeBusk, R.F., (1990) "Smoking cessation after acute myocardial infarction: effects of a nurse managed intervention", Annals of Internal Medicine,
113: 118-123.

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Tobacco and Cancer Programme International Union Against Cancer 3, Rue du Conseil-Général, 1205 Geneva, Switzerland Tel: (4122) 809 1830, Fax: (4122) 809 1810 E-mail: tobacco-control@globalink.org | Tobacco and Cancer Programme