A new initiative by the American Nurses Association, The Tobacco Free Nurses Initiative and the Robert Wood Johnson Foundation is striving to decrease the number of nurses addicted to tobacco, as well as increase nurses' effectiveness in urging patients to quit. 

 

 

Nurses are the primary educators of patients when it comes to influencing patients’ lifestyles and behaviors. We also know that it is much easier for a person to be influenced positively by another if the individual offering such influence practices what they preach. That said, it has long been scientifically accepted and documented that smoking causes a plethora of preventable illnesses, and that smoking cessation (or refusal to begin smoking from the start) is a key to increasing longevity and decreasing the risk of many life-threatening or debilitating illnesses.

If our over-arching goal as nurses is to influence our patients to alter their lifestyles in favor of healthier habits, it is clear that encouraging our patients to quit smoking should be a primary nursing goal figuring prominently in most every care plan. However, nurses who smoke are at a great disadvantage when it comes to advising patients on this critical issue, and there is likely truth to the assertion that nurses who smoke will have less success in influencing patients who smoke to quit. According to Tobacco Free Nurses, 15% of Registered Nurses smoke, and 28% of Licensed Practical Nurses smoke. Of note, these rates are higher than any other group of healthcare professionals.

The American Nurses Association/American Nurses Foundation has partnered with the Tobacco Free Nurses Initiative (funded by the Robert Wood Johnson Foundation) to educate nurses around the dangers of smoking, the need for smoking cessation education among all patient populations, and to decrease overall exposure to the harms of smoking and second-hand smoke. According to the ANA website, there are currently 2.2 million nurses working in the United States. If each of those nurses influenced one American to quit smoking, that would essentially triple the current U.S. quit rate. From their website:

“The Tobacco Free Nurses' mission is to ensure that the nursing profession is prepared to actively promote health by reducing nurses’ barriers to involvement in tobacco control, including lack of education, smoking among professionals, and lack of nursing leadership. Nurses must be equipped to assist with smoking cessation, prevent tobacco use, and promote strategies to decrease exposure to second hand smoke. The Tobacco Free Nurses initiative accomplishes its mission through:

1) Supporting and assisting smoking cessation efforts of nurses and nursing students;
2) Providing tobacco control resources for use in patient care;
3) Enhancing the culture of nurses as leaders and advocates of a smokefree society.”

Tobacco Free Nurses is the “first national program focused on helping nurses and student nurses to stop smoking.” Partnering with QuitNet , a special web-page specifically designed for nurses who smoke is available for those who wish to avail themselves of the many services and resources which QuitNet has to offer.

Interestingly, the Human Resource Management Guide (HRM) website recently mentioned the results of a study on nurses who smoke by the UCLA Jonsson Cancer Center. Conducted in 2005, the study found that smoking among nurses created a great deal of dissension and conflict within healthcare workplaces based upon perceptions---whether accurate or not---that nurses who smoke structure their workdays around smoke breaks, attempt to hide their addiction from patients, and serve as poor role models for patients who wish to quit smoking.

Nurses who smoke who were interviewed for the study expressed guilt about their smoking, citing frequent efforts to brush their teeth, wash their hands, and apply fragranced products to hide their habit from patients and families. Non-smoking colleagues complained that nurses who smoke take longer and more frequent breaks, and often return from breaks with a strong smell of smoke that simply cannot be erased. Overall, it was concluded that non-smoking healthcare professionals are more likely to influence patients to enter smoking cessation programs. It was also concluded that there is a dearth of smoking cessation programs specifically targeting nurses. The study concludes, "the benefits of supporting smoking cessation in the worksite could have an immediate positive impact on nurses' health, and might result in other positive outcomes (e.g., reduced sick time). The benefit to patients must also be emphasized, as non-smoking clinicians are more likely to provide cessation interventions than their smoking counterparts."

As clinicians, it is our responsibility to assist our patients to change their lifestyles to the extent that longevity and quality of life are enhanced. The Agency for Healthcare Research and Quality (AHRQ) strongly recommends that healthcare providers use all available resources to educate patients regarding the risks of tobacco use and second-hand smoke. A comprehensive guide for treating tobacco dependence is easily accessible on the AHRQ website, and a specific questionnaire for nurses to use when evaluating patients for tobacco use is available in html or pdf formats. Perusing the Healthy People 2010 government website, tobacco cessation is highlighted as a goal of the 2010 initiative, with an excellent webpage of resources readily available for the interested clinician or non-clinician.

Whether we smoke or not, whether we are obese or slim, and whether we engage in healthy lifestyle choices or not, nurses and all healthcare professionals have a sacred trust with the public to first do no harm, and to additionally practice in such a way that our work influences others to improve their health and increase their potential for longer, healthier lives. Whether we like it or not, the public does indeed look to healthcare professionals to lead lives worth emulating, just as we all expect our politicians and civil servants to lead lives free of corruption and malfeasance (and oh how they so often fail us, friends!) Still, healthcare professionals (and that includes us nurses) must take our own habits into consideration, examining our own lifestyles for ways in which we can better serve as role models for the society at large, eschewing unhealthy practices, and advocating those habits which will decrease illness and increase quality of life for all.

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NurseKeith is a writer, nurse, blogger, and consultant. Please feel free to visit his blog, Digital Doorway .  

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