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Nursing Interventions for Smoking Cessation
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The purpose of this entry is to synthesize the factors that are associated with smoking cessation intervention among nurses. We conducted a systematic search of the literature published from database inception through to 22 April 2020, in five electronic databases including Pubmed, CINAHL Plus, Scopus, Web of science, and ProQuest.

  • factors
  • nursing interventions
  • smoking cessation
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1. Introduction

The tobacco epidemic is one of the biggest public health threats the world has ever faced, resulting in more than eight million deaths a year around the world. More than seven million of those deaths are the result of direct tobacco use, while around 1.2 million are the result of non-smokers being exposed to secondhand smoke [1]. In light of this troubling fact, the international council of nurses (ICN) encourages member associations to co-ordinate their efforts with other national groups to bring government and public attention to the harmful health effects of tobacco and to encourage governments to reduce, discourage, and eliminate tobacco use, including providing access to cessation programs [2]. Nurses, representing the largest number of healthcare providers worldwide, are involved in most of these visits, and therefore have the potential for a profound effect on the reduction of tobacco use [3]. Additionally, a previous literature review reported that nurses and professional nursing organizations can make a significant difference in minimizing the disease burden caused by tobacco through nursing research, policy, practice, and education [4].

Nursing interventions for smoking cessation include various methods such as behavioral counseling for helping smokers to successfully quit smoking [5]. Regarding the effectiveness of nursing interventions for smoking cessation, the Agency for Health Care Research and Quality Clinical Practice Guideline (AHRQ) has reported that advice to stop smoking from nurses, as one of the many providers, could increase the rates of cessation [6]. The meta-analyses by Cochrane Collaboration reported that advice and support from nurses could increase people's success to quit smoking, whether in hospitals or in community settings [7][8]. Additionally, a previous cohort study, in Japan, reported the importance of nurses' counseling for assisting patients to achieve smoking cessation by maintaining patients' self-efficacy of smoking cessation [9]. Overall, nursing interventions for smoking cessation play an important role to help patients quit smoking successfully.

Nurses can be more effective as the first line of treatment due to the length of time they spend with patients [10]. In addition, there are many previous studies that have reported a variety of factors associated with nursing interventions for smoking cessation; however, there is no narrative review to synthesize the factors.

2. Discussion

In the results, we narratively synthesized the factors that were associated with nursing interventions for smoking cessation. There are five important points that need to be discussed. First, our results indicated that nurses who were current smokers were less likely to implement smoking cessation interventions [11][12][13][14], and nurses who were ex-smokers were more likely to implement smoking cessation interventions [15][16][17]. A previous study, in Northern Ireland, reported that qualified nurses who smoked were less motivated to provide cessation support for patients, had fewer positive attitudes about the value of smoking cessation, were less likely to have received smoking cessation training, and were less likely to want further training [18]. Another previous study reported that nonsmokers and ex-smokers showed a more positive attitude toward their roles as exemplars and in counseling the public about the health hazards of smoking than smokers among oncology nurses in Texas, USA [19]. Additionally, a systematic review with meta-analysis reported that nurses' personal smoking status was not significantly associated with nurses always asking patients about their smoking, assessing motivation and assisting patients to quit smoking, but nurses who smoked were 13% less likely to advise their patients to quit and 25% were less likely to arrange smoking cessation follow-up [20]. Overall, support and assistance for nurses to quit smoking are needed to strengthen nursing interventions for smoking cessation.

Secondly, our results indicate that nurses with prior smoking cessation training were more likely to implement smoking cessation interventions. A previous study, in the Czech Republic, reported that nurses' brief intervention skills including asking patients about smoking, recommendations to stop smoking, assessing willingness to quit, assisting with cessation, and recommending a smoke-free home were significantly improved after the completion of an e-learning program [21]. Additionally, two previous studies reported that nurses receiving web-based smoking cessation education significantly increased self-reports of frequency of providing interventions to patients who smoked, including recommending smoke-free home environments to support attempts to quit [22][23]. The meta-analyses by Cochrane Collaboration reported that healthcare professionals who had received training were more likely to perform tasks of smoking cessation [24]. Therefore, providing smoking cessation training can improve smoking cessation intervention skills, and then implement nursing interventions for smoking cessation.

Thirdly, our results indicate that nurses with positive attitudes and social influence for smoking cessation intervention were more likely to implement smoking cessation interventions. A previous focus group study reported that there is a need to build upon nurses' positive attitudes about engaging in smoking cessation interventions with patients to ensure that cessation interventions are standard nursing practice [25]. Additionally, previous studies reported that social influence towards smoking cessation intervention had a significant positive influence on determining the intention to implement smoking cessation intervention. Overall, positive attitudes and social influence regarding smoking cessation interventions can promote nursing interventions for smoking cessation.

Fourthly, our results indicate that nurses with higher self-efficacy and outcome expectations were more likely to implement smoking cessation interventions. A previous integrative review of the literature reported that attitude, innovation, perceived social influence, and self-efficacy were factors for occupational health nurses’ intention to implement smoking cessation interventions; therefore, improving occupational health nurses’ self-efficacy could guide changes in clinical practice for motivating smokers to quit [26]. Regarding the strategies to improve nurses’ attitudes and self-efficacy, a previous study, in India, reported that adequate experience in a center for addiction medicine improved nurses' positive attitude and self-efficacy, and therefore helped to provider substantial care to patients with addiction problem [27]. Therefore, improving nurses’ self-efficacy is needed to strengthen nursing interventions for smoking cessation.

Finally, our results also indicate that nurses with higher self-efficacy to engage in smoking counseling were more likely to implement smoking cessation interventions [19,22,25]. A previous study, in Japan, reported that research utilization competency was positively associated with self-efficacy and prenatal smoking cessation interventions among public health nurses [28]. Additionally, another study including 1054 primary healthcare nurses, in Sweden, reported that the ability and use of research were significant determinants of attitudes towards research and use of research findings [29]. Overall, nurses with higher research utilization ability were more likely to implement smoking cessation interventions.

References

  1. World Health Organization (WHO). Tobacco: Key Facts. Available online: https://www.who.int/news-room/fact-sheets/detail/tobacco (accessed on 24 August 2020).
  2. The International Council of Nurses (ICN). Tobacco Use and Health. Available online: https://www.icn.ch/sites/default/files/inline-files/A18_Tobacco_Use_Health.pdf (accessed on 27 August 2020).
  3. Youdan, B.; Queally, B. Nurses’ role in promoting and supporting smoking cessation. Nurs. Times 2005, 101, 26.
  4. Sarna, L.; Bialous, S.A.; Chan, S.S.; Hollen, P.; O’Connell, K.A. Making a difference: Nursing scholarship and leadership in tobacco control. Nurs Outlook. 2013, 61, 31–42.
  5. Kazemzadeh, Z.; Manzari, Z.S.; Pouresmail, Z. Nursing interventions for smoking cessation in hospitalized patients: A sys-tematic review. Int. Nurs. Rev. 2017, 64, 263–275.
  6. Fiore, M.C.; Jaen, C.R.; Baker, T.B.; Bailey, W.C.; Benowitz, N.L.; Curry, S.J.; Dorfman, S.F.; Froelicher, E.S.; Goldstein, M.G.; Healton, C.G.; et al. Treating Tobacco Use and Dependence: 2008 Update; US Dept of Health and Human Services: Rockville, MD, USA, 2008.
  7. Rice, V.H.; Hartmann-Boyce, J.; Stead, L.F. Nursing interventions for smoking cessation. Cochrane Database Syst Rev. 2013, 12, CD001188.
  8. Rice, V.H.; Heath, L.; Livingstone-Banks, J.; Hartmann-Boyce, J. Nursing interventions for smoking cessation. Cochrane Da-tabase Syst Rev. 2017, 12, CD001188.
  9. Taniguchi, C.; Tanaka, H.; Saka, H.; Oze, I.; Tachibana, K.; Nozaki, Y.; Suzuki, Y.; Sakakibara, H. Changes in self-efficacy associated with success in quitting smoking in participants in Japanese smoking cessation therapy. Int. J. Nurs. Pract. 2018, 24, e12647.
  10. Sarna, L. Smoking Cessation in Nursing. Available online: https://mdquit.org/providers/nurses (accessed 17 January 2021).
  11. Sarna, L.; Bialous, S.A.; Wells, M.; Kotlerman, J.; Wewers, M.E.; Froelicher, E.S. Frequency of nurses’ smoking cessation in-terventions: Report from a national survey. J. Clin Nurs. 2009, 18, 2066–2077.
  12. Sarna, L.; Bialous, S.; Ong, M.; Wells, M.; Kotlerman, J. Nurses’ treatment of tobacco dependence in hospitalized smokers in three states. Res. Nurs. Health. 2012, 35, 250–264.
  13. Sarna, L.P.; Bialous, S.A.; Králíková, E.; Kmetova, A.; Felbrová, V.; Kulovaná, S.; Malá, K.; Roubíčková, E.; Wells, M.J.; Brook, J.K. Tobacco Cessation Practices and Attitudes among Nurses in the Czech Republic. Cancer Nurs. 2015, 38, E22–E29.
  14. Taniguchi, C.; Hibino, F.; Kawaguchi, E.; Maruguchi, M.; Tokunaga, N.; Saka, H.; Oze, I.; Ito, H.; Hiraki, A.; Nakamura, S.; et al. Perceptions and practices of Japanese nurses regarding tobacco intervention for cancer patients. J. Epidemiol. 2011, 21, 391–397.
  15. Tremblay, M.; Cournoyer, D.; O’Loughlin, J. Do the correlates of smoking cessation counseling differ across health profes-sional groups? Nicotine Tob Res. 2009, 11, 1330–1338.
  16. Wetta-Hall, R.; Ablah, E.; Frazier, L.M.; Molgaard, C.A.; Berry, M.; Good, M.J. Factors Influencing Nurses’ Smoking Cessa-tion Assessment and Counseling Practices. J. Addict. Nurs. 2005, 16, 131–135.
  17. Yankie, V.M.; Price, H.M.; Nanfito, E.R.; Jasinski, D.M.; Crowell, N.A.; Heath, J. Providing smoking cessation counseling: A national survey among nurse anesthetists. Crit. Care Nurs. Clin. North. Am. 2006, 18, 123–129.
  18. Slater, P.; McElwee, G.; Fleming, P.; McKenna, H. Nurses’ smoking behaviour related to cessation practice. Nurs. Times. 2006, 102, 32–37.
  19. Reeve, K.; Adams, J.; Kouzekanani, K. The nurse as exemplar: Smoking status as a predictor of attitude toward smoking and smoking cessation. Cancer Pr. 1996, 4, 31–33.
  20. Duaso, M.J.; Bakhshi, S.; Mujika, A.; Purssell, E.; While, A.E. Nurses’ smoking habits and their professional smoking cessa-tion practices. A systematic review and meta-analysis. Int. J. Nurs Stud. 2017, 67, 3–11.
  21. Králíková, E.; Felbrová, V.; Kulovaná, S.; Malá, K.; Nohavová, I.; Roubíčková, E.; Pánková, A.; Bialous, S.A.; Wells, M.J.; Brook, J.; et al. Nurses’ Attitudes toward Intervening with Smokers: Their Knowledge, Opinion and E-Learning Impact. Cent. Eur. J. Public Health. 2016, 24, 272–275.
  22. Sarna, L.; Bialous, S.A.; Zou, X.N.; Wang, W.; Hong. J.; Wells, M.; Brook, J. Evaluation of a web-based educational pro-gramme on changes in frequency of nurses' interventions to help smokers quit and reduce second-hand smoke exposure in China. J. Adv Nurs. 2016, 72, 118–126.
  23. Sarna, L.; Bialous, S.A.; Wells, M.; Brook, J. Impact of a webcast on nurses' delivery of tobacco dependence treatment. J. Clin Nurs. 2018, 27, e91–e99.
  24. Carson, K.V.; Verbiest, M.E.; Crone, M.R.; Brinn, M.P.; Esterman, A.J.; Assendelft, W.J.; Smith, B.J. Training health profes-sionals in smoking cessation. Cochrane Database. Syst. Rev. 2012, 5, CD000214.
  25. Rezk-Hanna, M.; Sarna, L.; Petersen, A.B.; Wells, M.; Nohavova, I.; Bialous, S. Attitudes, barriers and facilitators to smoking cessation among Central and Eastern European nurses: A focus group study. Eur. J. Oncol Nurs. 2018, 35, 39–46.
  26. Thornberry, A.; Garcia, T.J.; Peck, J.; Sefcik, E. Occupational Health Nurses' Self-Efficacy in Smoking Cessation Interven-tions: An Integrative Review of the Literature. Workplace Health Saf. 2020, 68, 533–543.
  27. Banu, M.R. Nurses Attitude and Self-Efficacy in Smoking Cessation Care to Hospitalized Patients. Int. Arch. Subst. Abuse Rehabil. 2018, 1, 1.
  28. Li, M.; Okamoto, R.; Tada, A.; Kiya, M. Factors Associated with Prenatal Smoking Cessation Interventions among Public Health Nurses in Japan. Int. J. Env. Res. Public Health 2020, 17, 6135.
  29. Nilsson Kajermo, K.; Alinaghizadeh, H.; Falk, U.; Wändell, P.; Törnkvist, L. Psychometric evaluation of a questionnaire and primary healthcare nurses’ attitudes towards research and use of research fifindings. Scand. J. Caring Sci. 2014, 28, 173–185.
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Subjects: Nursing
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Update Time: 25 Mar 2021
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    Li, M. Nursing Interventions for Smoking Cessation. Encyclopedia. Available online: https://encyclopedia.pub/entry/7548 (accessed on 09 August 2022).
    Li M. Nursing Interventions for Smoking Cessation. Encyclopedia. Available at: https://encyclopedia.pub/entry/7548. Accessed August 09, 2022.
    Li, Meng. "Nursing Interventions for Smoking Cessation," Encyclopedia, https://encyclopedia.pub/entry/7548 (accessed August 09, 2022).
    Li, M. (2021, February 24). Nursing Interventions for Smoking Cessation. In Encyclopedia. https://encyclopedia.pub/entry/7548
    Li, Meng. ''Nursing Interventions for Smoking Cessation.'' Encyclopedia. Web. 24 February, 2021.
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