Academic journal article International Journal of Child Health and Human Development

Personal Experiences with Smoking among Nursing Students: A Pilot Focus Group Study

Academic journal article International Journal of Child Health and Human Development

Personal Experiences with Smoking among Nursing Students: A Pilot Focus Group Study

Article excerpt


Cigarette smoking continues to be the leading cause of preventable morbidity and mortality in the United States and worldwide (1,2). While the prevalence of smoking has declined since the release of the 1964 US Surgeon General's Report (3,4), it is still estimated that currently one in five adults still smoke (5). A national health objective for 2020 is to reduce adult smoking prevalence to 12% and increase cessation attempts to 80% (6) . In order to attain these health objectives, it is necessary for healthcare practitioners to reach and treat all smokers with cessation assistance whenever the opportunity is given. Healthcare practitioners, especially nurses, are in a prime position to aid in the national effort to reduce tobacco use. It is however, increasingly important that these nurses receive the appropriate amount of education to more effectively offer smoking cessation advice to patients.

To make progress in reducing smoking, the MPOWER Framework was developed and outlines six effective strategies to reduce tobacco use. These strategies include: monitor, protect, offer, warn, enforce, and raise (2). The strategy of "offer", focuses on the role of healthcare professionals (2) to effectively provide cessation treatments, and educate patients about the dangers of smoking; including exposure to secondhand smoke. Thus, the nursing profession plays an integral role in supporting smoking cessation through the patient-healthcare provider encounter by screening and offering cessation treatments to patients.

Entry-level nurses have the unique ability to affect three areas of this model, namely: protecting people from tobacco smoke, offering to help quit tobacco use, and to warn about the dangers of tobacco (2). In addition, the Public Health Services (PHS) Guidelines recommends health care providers ask, advise, assess, assist, and arrange (5 A's) in efforts to help patients quit smoking (7). However, implementing even a simple intervention such as asking patients about smoking may prove challenging for nurses who have not gone through formal training in the area of smoking cessation.

While there have been significant declines in the rates of smoking among nurses over the past several decades, smoking still seems to be more prevalent among nurses and nursing subspecialty when compared to other healthcare professionals such as physicians (8). For example, Nelson et al (1994), reported that in the 1990's 18.3% of nurses smoked, while only 3.3% of physicians smoked. Using the 2001-2002 Tobacco Use Supplement of the Current Population Survey 14.8% of nurses were current smokers compared to 1% of physicians surveyed in 2005 (9-11). While data from the 2002/2003 follow- up from Nurses Health Study, indicated that 8.4% of nurses were current smokers (8), Sama et al (2010), reported that in 2006-2007, 20.6% of LPNs smoked and that respiratory therapists came in a close second at 19.3% (12). This data is concerning in that it demonstrates the high prevalence of smoking within the patient care provider community, such as nurses.

The practice of nursing has always focused on holistic patient care (13-15), and emphasizes understanding the process of healing and recovery in overall patient well-being. Nurses serve as a primary point of contact for patient care, and can play an integral role in helping patients quit smoking. Thus, understanding the smoking cessation process is an integral part of the nurses' role in helping patients to successfully quit. The assessment of personal experiences with smoking and smoking cessation among nursing students may provide an additional level of education that may otherwise not be obtained from textbooks or nursing curriculum (10). While current nursing curriculum includes health effects of smoking, it is helpful to understand nursing students' knowledge of the quit process. Thus, a pilot focus group study was conducted among former and never smoking nursing students with the purpose to better understand their knowledge about smoking behaviors and quitting. …

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