Field of Work: Helping nurses quit smoking.
Problem Synopsis: Studies have shown that the nation's 3 million nurses—the largest single group of clinicians in the country—are very effective in helping people stop smoking. Despite their potential, nurses have been an underused resource in tobacco control efforts. The 1995–1996 Current Population Survey showed that smoking prevalence among registered nurses (R.N.s) was 16.2 percent; among licensed practical nurses (L.P.N.s), it was 30.4 percent. R.N.s and L.P.N.s had the highest rates of current smoking among all health care professionals. In addition to the challenge of individual nurses who smoke, the nursing profession as a whole had offered limited leadership in the tobacco-control movement.
Synopsis of the Work: In 2003, a team from the University of California, Los Angeles (UCLA), School of Nursing launched Tobacco-Free Nurses, the first national effort created to help nurses quit smoking, provide resources to nurses who want to help their patients quit and promote tobacco control on the agenda of nursing organizations. Partners on this project included the American Association of Colleges of Nursing, American Nurses Foundation/American Nurses Association, the National Coalition of Ethnic Minority Nurse Associations and the National Federation of Licensed Practical Nurses.
Key Results: From 2003 to 2008, the project team:
- Created www.tobaccofreenurses.org, a Web site that includes up-to-date information for nurses on all aspects of tobacco control, facilitates communication among nurses and provides links to tobacco control resources.
- Launched Nurses QuitNet® which provided online cessation support to over 2,200 nurses. Nurses who registered for the program received support, cessation skills training and access to medication resources and information at no cost.
- Developed a pocket guide to help nurses support their patients who want to quit smoking.
- Held a national summit on tobacco control, attended by leaders of 21 diverse nursing organizations representing over 480,000 nurses, and a "first ever" nursing research conference focused on tobacco cessation.
- Engaged national media, made presentations, held trainings and published in peer-reviewed journals to highlight issues relevant to tobacco in nursing.
- In a survey of 163 Black nurses, the majority (92 percent) agreed that nurses should be involved in helping patients quit. However, 89 percent reported that nurses need more knowledge and skills about cessation interventions.
- In focus groups with 60 current and former nurse smokers, the majority (81 percent) reported starting or continuing to smoke in nursing school, but only 29 percent reported receiving any help with cessation.
- According to focus groups participants, the perception that nurse smokers take more and longer breaks and were less available for patient care was a source of conflict in the work environment.
- Nurses continue to smoke at much higher rates than other health professionals although their smoking rates have declined considerably, according to data from the Nurses' Health Study. By 2002–2003, 8.4 percent of all study participants continued to smoke, compared to 33.2 percent in 1976.
- A Web-based survey of some 4,000 nurses suggested that nurses familiar with the Tobacco-Free Nurses initiative are significantly more likely to deliver smoking cessation interventions to their patients.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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