~ For Health Promotion ~
Eureka Hospital In-patient Unit
A bit of history:
• Cigarettes were provided free to
all of our troops during World
Wars I & II, & Korea, including the
• 1933- The Journal of the
American Medical Association
publishes its first cigarette ad, a
practice that would continue for
• Some physicians would even
advise that their patients start
smoking to help deal with anxiety
& stress issues.
• Not only could patients smoke in
their rooms, but staff could smoke
in the nurses station!
Media played a role:
But glamour only goes so far…
Beautiful Betty Grable, died of
lung cancer aged 56.
Humphrey Bogart, smoking
glamour personified, would light
up, "One for me and one for my
chick." Died at 57 of esophageal
Lung cancer stopped Lucille Ball
and DesiArnaz in their prime.
Singer, Nat King Cole? He died of
lung cancer aged 45.. YulBrynner
and Robert Mitchum — lung
cancer. Lana Turner and The
Marlboro Man — throat cancer.
~ all died prematurely from smoking.
(Sulzberger & Bates, n.d.)
The truth emerges:
Early anti-smoking campaigns
• But, society came to realize through
mortality statistics and research that
smoking REALLY KILLS! We can’t
claim we ―didn’t know‖ anymore!
• Early smoking cessation campaigns
were shocking. Unfortunately, they
didn’t get to the heart of the
• Smoking cessation education needs
to be bold and to the point: face to
• While patients are hospitalized is the
BEST time to talk to them about
quitting smoking. It’s the ―window of
opportunity,‖ or ―teachable moment,‖
particularly if they are there for a
lung ailment or smoking related
To name a few… more discovered all the time
Hard core stats:
• The use of tobacco is the
single most prevalent
preventative cause of
mortality in the world
• About half of all
continuing smokers will
die from smoking related
• Currently 1 in 5 deaths can
be contributed to
• By the year 2020, it is
estimated that smoking
• Continued smoking
causes an average loss of
20-25 years life
expectancy per smoker!
Why do nurses smoke more?
• Major paradox: nurses can tend to
have a higher prevalence rate of
smoking than the general public.
• The National League for Nursing
reports overall, nurses’ smoking
rates are 18%, with some studies
reporting as high as 24%. The
general public is only 20.8-22.5%
depending on which study you read.
• ECH is certainly no different. The
smoking rate among regularly
scheduled staff nurses here on the
in-patient unit is noted to be 50%.
• Studies say respondents report
addiction, enjoyment, peer influence
and stress as causes.
• 34.9% of smoking nurses did not wish
to quit. What do you think might be
the cause? Motivation is a significant
predictor of cessation.
Are you ready to quit?
(Halcomb, 2005; McKenna, 2001;
It’s an addiction…
• It’s a physical addiction, with denial,
justification, and rationalization…
Smokers often don’t realize: it’s
insidious & cunning.
• There are a vast amount of support
and resources available to help.
• Multiple web sites/phone lines.
Check the internet! Literature &
• Insurance and/or flex account for
• Medications (OTC or prescription):
• Nicotine substitutes
• Check out
Real help for quitters!
• CHANTIX – binds with nicotine
receptors in the brain to remove
the desire. It’s a fairly new
prescription medication that has
online help, and phone support
for all it’s patients!
• Check out www.chantix.com
• Talk to your doctor about your
plan to quit!
• There’s a web site just for
nurses, to help quit!!!
Tobacco Free Nurses:
• American Heart Association
…And, evidence shows
that the majority of
WANT TO QUIT!
Myths about quitting:
Just to name a few…
• If I quit smoking, I’ll gain
too much weight. It’s better
to lose the weight first.
• I’ve tried to quit before and
failed. I don’t like feeling
like a failure.
• It costs too much for the
smoking cessation aids
that are on the market.
• My spouse smokes; I can’t
ask others to quit.
• How much weight have you lost
smoking so far? The risks of
smoking far exceed the risks of
a few pounds of weight gain.
• It usually takes more than one
attempt to quit for good.
• Consider the costs of a month
of cigarettes, doctor bills,
cigarette burn holes in things…
• Smoking in the garage is a
great way to start making
Why don’t we teach more?
• We often feel inadequate to
approach smokers with
smoking cessation education.
• If the staff member smokes,
―How can I ask the patient to
quit when I smoke?‖
• I don’t want to offend anyone.
• The patient would be more
open to listening to his/her own
• Patients do listen to the advice
of health care providers,
particularly when hospitalized.
• Consider your reluctance; it’s
contributing to shortened lives
of smokers you don’t teach.
• Genuine caring isn’t offensive.
• The more people who educate
and encourage, the more likely
patients will be successful.
We’ve come a long way baby…
• Devastating effects of tobacco are
so extreme that the World Health
Organization (WHO) has
established a Code of Conduct
requiring nurses to:
• Act as role models of smoking
• Assess clients tobacco use.
• Give advice on how to quit.
• Participate in tobacco-control
• Support tobacco-free public places
and refrain from accepting money
from tobacco companies.
• Tobacco control must occur at the
(Halcomb, 2005, p. 209)
We could soon be
required to do all of
these things in our
We need to ask ourselves…
Wouldn’t it be
of our friend
February 21, 1951
June 23, 2008
American Heart Association (2008). Smoking cessation guidelines. American
Heart Association. Retrieved October 14, 2008 from
Barta, S. K., & Stacy, R. D. (2005). The effects of a theory-based training
program on nurses’ self-efficacy and behavior for smoking cessation
counseling. Journal of Continuing Education in Nursing, 36(3), 117-123.
Boardman, T., Catley, D., Mayo, M. S., &Ahluwalia, J. S. (2005). Self-efficacy
and motivation to quit during participation in a smoking cessation program.
International Journal of Behavioral Medicine, 12(4), 266-272.
Halcomb, K. A. (2005). Smoke-free nurses: Leading by example. American
Association of Occupational Health Nurses. 53(5), 209-212.
Hinnen, R. (October 14, 2008). Personal communication.
McKenna, H., Slater, P., McCance, T., Bunting, B., Spiers, A., &McElwee, G.
(2001). Qualified nurses' smoking prevalence: their reasons for smoking and
desire to quit. Journal of Advanced Nursing, 35(5), 769-775.
Pfizer (2008). Quitting- CHANTIX official site. Retrieved on October 14, 2008 from
QuitSmoking.com (2008). Zyban quit smoking drug. Retrieved October 14, 2008 from,
Sulzberger, P. & Bates, M. (n.d.) The real story on smoking glamour . The ultimate
quit smoking guide. Retrieved October 13, 2008 from,
Tobacco Free Nurses (2006). Tobacco free nurses-join nurses quitnet today.
Retrieved October 14, 2008 from, http://www.tobaccofreenurses.org/quit.php
Tobacco.org (2008). The tobacco timeline. Tobacco news and information. Retrieved
October 14, 2008 from http://www.tobacco.org/History/Tobacco_History.html
Whyte, R. E., Watson, H. E., & McIntosh, J. (2006). Nurses’ opportunistic
interventions with patients in relation to smoking. Journal of Advanced Nursing.