Smoking Cessation ~ For Health Promotion ~ For Nurses and Anyone Who Cares about smokers

A bit of history: Remember When… Smoking was identified as glamorous?

Smoking was

identified as glamorous?

medical history: Remember When… Cigarettes were provided free to all of our troops during World Wars I & II, & Korea, including the hospitalized soldiers. 1933- The Journal of the American Medical Association publishes its first cigarette ad, a practice that would continue for 20 years. 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! (R. Hinnen; Tobacco news)

Cigarettes were provided free to all of our troops during World Wars I & II, & Korea, including the hospitalized soldiers.

1933- The Journal of the American Medical Association publishes its first cigarette ad, a practice that would continue for 20 years.

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!

(R. Hinnen; Tobacco news)

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 cancer. Lung cancer stopped Lucille Ball and Desi Arnaz in their prime. Singer, Nat King Cole died of lung cancer age 45. Yul Brynner and Robert Mitchum - lung cancer. Lana Turner and The Marlboro Man - throat cancer. ~ all died prematurely from smoking . (Ultimate quit smoking guide)

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 cancer.

Lung cancer stopped Lucille Ball and Desi Arnaz in their prime.

Singer, Nat King Cole died of lung cancer age 45. Yul Brynner and Robert Mitchum - lung cancer. Lana Turner and The Marlboro Man - throat cancer.

~ all died prematurely from smoking .

(Ultimate quit smoking guide)

The truth emerges: early anti-smoking campaigns Society came to realize through mortality statistics and research that smoking KILLS! Early smoking cessation campaigns were shocking. Unfortunately, they didn’t get to the heart of the problem. Smoking cessation education needs to be bold and to the point: face to face. Talking to patients while hospitalized is the BEST time; it’s the “window of opportunity,” or “teachable moment,” particularly if they are there for a lung ailment or smoking related illness. (Barta, p. 117, Whyte, p. 569)

Society came to realize through mortality statistics and research that smoking KILLS!

Early smoking cessation campaigns were shocking. Unfortunately, they didn’t get to the heart of the problem.

Smoking cessation education needs to be bold and to the point: face to face.

Talking to patients while hospitalized is the BEST time; it’s the “window of opportunity,” or “teachable moment,” particularly if they are there for a lung ailment or smoking related illness. (Barta, p. 117, Whyte, p. 569)

Health effects: 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 today. About half of all continuing smokers will die from smoking related diseases. Currently 1 in 5 deaths can be contributed to smoking. By the year 2020, it is estimated that smoking will be the absolute leading cause of death. Continued smoking causes an average loss of 20-25 years life expectancy per smoker! (Barta, p. 117; Puska, p. 447)

The use of tobacco is the single most prevalent preventative cause of mortality in the world today.

About half of all continuing smokers will die from smoking related diseases.

Currently 1 in 5 deaths can be contributed to smoking.

By the year 2020, it is estimated that smoking will be the absolute leading cause of death.

Continued smoking causes an average loss of 20-25 years life expectancy per smoker!

(Barta, p. 117; Puska, p. 447)

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 do 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, p. 209; McKenna, pps. 769-70; Boardman, p. 266)

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 do 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, p. 209; McKenna, pps. 769-70; Boardman, p. 266)

chronic smoking: it’s an addiction…

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! 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: http://www.tobaccofreenurses.org/quit.php American Heart Association provides guidelines: http://www.americanheart.org/presenter.jhtml?identifier=4735 … And, evidence shows that the majority of smokers DO WANT TO QUIT!

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! 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: http://www.tobaccofreenurses.org/quit.php

American Heart Association provides guidelines: http://www.americanheart.org/presenter.jhtml?identifier=4735

… And, evidence shows that the majority of smokers DO WANT TO QUIT!

Myths about quitting : just to name a few… MYTH 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. TRUTH 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 changes!

MYTH

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.

TRUTH

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 changes!

Smoking cessation: Why don’t we teach more? Our Perceptions 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 doctor. Patient’s Reality 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.

Our Perceptions

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 doctor.

Patient’s Reality

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.

Overwhelming evidence: 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 cessation. Assess client’s tobacco use. Give advice on how to quit. Participate in tobacco-control activities. Support tobacco-free public places Refrain from accepting money from tobacco companies. Tobacco control must occur at the individual level. (Halcomb, p. 209)

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 cessation.

Assess client’s tobacco use.

Give advice on how to quit.

Participate in tobacco-control activities.

Support tobacco-free public places

Refrain from accepting money from tobacco companies.

Tobacco control must occur at the individual level.

(Halcomb, p. 209)

Count the cost ! If the 2.2 million nurses in the U.S. each helped one person annually quit smoking, nurses would help triple the U.S. quit rate. (Tobacco Free Nurses) Knowing this… We need to ask ourselves… Wouldn’t it be worth it?

If the 2.2 million nurses in the U.S. each helped one person annually quit smoking, nurses would help triple the U.S. quit rate.

(Tobacco Free Nurses)

Knowing this…

We need to ask ourselves…

Wouldn’t it be worth it?

References American Heart Association. Retrieved October 14, 2008 from http://www.americanheart.org/presenter.jhtml?identifier=4735 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. Chantix. Retrieved on October 14, 2008 from http://www.chantix.com/ 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.

American Heart Association. Retrieved October 14, 2008 from http://www.americanheart.org/presenter.jhtml?identifier=4735

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.

Chantix. Retrieved on October 14, 2008 from http://www.chantix.com/

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.

References 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. The ultimate quit smoking guide. Retrieved October 13, 2008 from http://www.quitguide.com/smoking-glamour.html Tobacco Free Nurses. Retrieved October 14, 2008 from http://www.tobaccofreenurses.org/quit.php 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. 55(5), 568-577. Zyban. Retrieved October 14, 2008 from http://www.quitsmoking.com/zyban/index.htm

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.

The ultimate quit smoking guide. Retrieved October 13, 2008 from http://www.quitguide.com/smoking-glamour.html

Tobacco Free Nurses. Retrieved October 14, 2008 from http://www.tobaccofreenurses.org/quit.php

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. 55(5), 568-577.

Zyban. Retrieved October 14, 2008 from http://www.quitsmoking.com/zyban/index.htm