Participation of Icelandic nurses in smoking cessation counselling

Aims and objectives. The purpose of this study was to investigate the participation and knowledge of Icelandic nurses in smoking cessation counselling and to find barriers to smoking interventions by nurses. Background. Research has shown that clinical intervention as brief as three minutes can substantially increase smoking cessation success. Several studies have revealed that majority of nurses agree that smoking cessation counselling is within their duties. However, the percentage of nurses who report advising and/or counselling patients remains low. Design and methods. An anonymous mail survey of all practicing nurses in Iceland was conducted in September 2004. A self‐administered questionnaire was used, consisting of 74 questions in six sections: asking about smoking behaviour, to advise, to assess/assist/arrange, children and passive smoking, other questions and demographic questions. Results. Of 2453 questionnaires, 868 complete questionnaires were returned, giving a 36% response rate. While the majority of nurses ‘asked’ about smoking behaviour, a minority ‘advised’ or ‘assisted’ their clients with smoking cessation. However, if the clients had no smoking‐related symptoms, less than half of the nurses asked about smoking behaviour. Failure to ask and advise clients about the importance of smoking cessation and assisting with smoking cessation correlated (p < 0·001) with several factors, including: lack of time, insufficient knowledge or training and not considered as a part of daily duty. Nurses who smoked were less likely to advise against smoking (p < 0·05). Conclusions. Nurses frequently neglect to counsel clients about smoking cessation. Common barriers to the delivery of smoking cessation interventions by nurses include insufficient education and training in smoking cessation therapy. Relevance to clinical practice. The number of patients with tobacco‐related illnesses is increasing worldwide. Effective smoking cessation interventions by nurses have the enormous potential of reducing smoking prevalence and improve health.     

Nurse adherence to a minimal-contact smoking cessation intervention on cardiac wards

Health promotion interventions are often underused by care practitioners and, therefore, are not effective. In this study, we assessed nurses' use of a smoking cessation intervention in Dutch cardiac wards and factors associated with their adherence. Ninety-four of 206 nurses did not fully apply the intervention in daily practice; they did not always provide patients with self-help guides, discuss smoking cessation aids, or provide follow-up care. The significant factors in our integrated change model accounted for 52% of the variance in adherence. Adherence was most likely if nurses consistently used an intervention card, perceived advantages of the intervention, had other nurses around them who used it, and had been involved in decision-making.     

Self-efficacy with application to adolescent smoking cessation: a concept analysis

Title.  Self-efficacy with application to adolescent smoking cessation: a concept analysis.
Aim.  This paper is a report of a concept analysis of adolescent smoking cessation self-efficacy.
Background.  Smoking cessation is a key preventive care/health promotion strategy offered by nurses worldwide. Most programming is tailored to adults although the reasons for smoking, along with coping strategies, resources and developmental stage, differ in adolescence. Understanding of the concept of self-efficacy as it relates to the adolescent population will assist nurses in addressing smoking cessation behaviours with this population.
Data sources.  The CINAHL and Proquest Nursing databases were searched for papers published between 1977 and 2007 using the keywords self-efficacy, adolescents and smoking cessation. The Walker and Avant method of concept analysis was applied.
Findings.  Adolescent smoking cessation self-efficacy is the confidence, perceived capacity and perceived ability that the teen possesses to quit smoking. Identified antecedents include developmental stage, past life support, emotional support, coping strategies, resources and emotional status. Consequences are smoking cessation: positive or negative. Empirical measures are identified.
Conclusion.  Levels of self-efficacy have been shown to be an important consideration in the approach of nurses to smoking cessation counselling with the adolescent client. The theoretical definition for this concept will provide the basis for nurses to design appropriate interventions for use in smoking cessation programmes targeted to adolescents. This definition identifies the key attributes of this concept that should be addressed when caring for this population.     

Nurses'' Tobacco-Related Knowledge, Attitudes, and Practice in Four Major Cities in China

PURPOSE: To (a) identify Chinese nurses' tobacco-related knowledge, attitude, and practice (KAP), including perception of competency in smoking-cessation interventions; (b) identify barriers and facilitators to smoking cessation interventions to patients; and (c) assess the learning needs and smoking status of nurses. Design: A cross-sectional survey was conducted in four major cities (Beijing, Shanghai, Guangzhou, and Chongqing) in China from November to December 2003. METHODS: 2,888 registered nurses working in hospitals affiliated with five university schools of nursing in these cities were invited to complete a questionnaire. An instrument used to assess tobacco-related KAP in Hong Kong was translated into Chinese and pilot tested to ensure reliability and validity. FINDINGS: 2,179 questionnaires were returned and after exclusion of the grossly incomplete questionnaires, 1,690 were included in the present analysis. Only 2% of participants were current and 1% were former smokers; most had not received training for smoking-cessation interventions as part of their nursing education program. Two-thirds recognized smoking as a leading cause of preventable death and that smoking cessation was the most cost effective intervention, but only a third routinely assisted patients' quit attempts. Nurses who received training reported greater competence in providing smoking-cessation intervention, and more frequent practice of cessation interventions. CONCLUSIONS: Chinese nurses had some knowledge about the health effects of tobacco use, but seldom practiced smoking-cessation interventions. Those who had prior training had greater competence and more practice. Including tobacco control, especially smoking cessation, in nursing curricula in China has the potential to save millions of lives.     

Frequency of nurses’ smoking cessation interventions: report from a national survey

Aims and objectives. To describe the frequency of nurses’ delivery of tobacco cessation interventions (‘Five A’s’: Ask, Advise, Assess, Assist, Arrange) and to determine the relationship of interventions to nurses’ awareness of the Tobacco Free Nurses initiative. Background. Tobacco cessation interventions can be effectively provided by nurses. The delivery of smoking cessation interventions by healthcare providers is mandated by several organisations in the USA and around the world. Lack of education and resources about tobacco cessation may contribute to the minimal level of interventions. The Tobacco Free Nurses initiative was developed to provide nurses with easy access to web‐based resources about tobacco control. Design. Cross‐sectional survey of nurses (n = 3482) working in 35 Magnet‐designated hospitals in the USA (21% response rate). Method. A valid and reliable questionnaire used in previous studies to assess the frequency of the nurse’s delivery of smoking cessation interventions (‘Five A’s’) was adapted for use on the web. Results. The majority of nurses asked (73%) and assisted (73%) with cessation. However, only 24% recommended pharmacotherapy. Only 22% referred to community resources and only 10% recommended use of the quitline. Nurses familiar with TFN (15%) were significantly more likely to report delivery of all aspects of interventions, including assisting with cessation (OR = 1·55, 95% CI 1·27, 1·90) and recommending medications (OR = 1·81, 95% CI 1·45, 2·24). Conclusions. Nurses’ delivery of comprehensive smoking cessation interventions was suboptimal. Awareness of Tobacco Free Nurses was associated with increased interventions. Relevance to clinical practice. Further efforts are needed to ensure that nurses incorporate evidence‐based interventions into clinical practice to help smokers quit. These findings support the value of Tobacco Free Nurses in providing nurses with information to support patients’ quit attempts.     

Psychiatric nurses' ethical stance on cigarette smoking by patients: determinants and dilemmas in their role in supporting cessation

It has been argued that psychiatric nurses are ideally placed to provide smoking cessation interventions to patients with mental illness. This assumes that psychiatric nurses actively support smoking cessation. The current paper articulates some of the reasons why this has not occurred, in particular, some of the ethical beliefs held by nurses that may prevent such activity. Such an assumption also discounts the evidence that confirms psychiatric nurses to have among the highest smoking rates in nursing and in the health professions in general. The role and impact of the institution are also considered. In-depth interviews with seven community and inpatient psychiatric nurses were thematically analysed. Extensive individual and group discussions were also held with inpatient nurses from open and locked psychiatric settings during participant observation of the settings. The findings suggest that psychiatric nurses can be more effective in the primary care role of supporting patients' smoking cessation if they receive adequate institutional support to do so.     

The midwife's role in providing smoking cessation interventions for pregnant women: The views of midwives working with high risk,disadvantaged women in public sector antenatal services in South Africa

ObjectiveThe purpose of this study was to assess the knowledge, attitudes, beliefs and current practices of South Africa midwives in relation to providing smoking cessation education or counselling to pregnant women. This was with a view to involving them in a potential smoking cessation intervention, targeting a sub-group of South African women who are at particularly high risk of the adverse pregnancy outcomes associated with smoking.DesignA cross-sectional survey of midwives, supplemented by individual, in depth, qualitative interviews.SettingPublic sector antenatal clinics serving this particular community of women in five of the major urban centres of South Africa.ParticipantsA total of 102 midwives were surveyed across 29 antenatal clinics and 24 were interviewed.MeasurementsSelf-administered survey and semi-structured, individual interviews describing constructs from the Theory of Planned Behaviour with respect to the provision of smoking cessation education/counselling, including: knowledge, attitudes, subjective norms and perceived behavioural control.FindingsThe majority of midwives accepted that providing smoking cessation advice was a part of their remit, perceived prevailing social norms to be supportive and were, overall, positively predisposed to participating in a smoking cessation intervention in antenatal clinics. However, the study identified a number of constraints to midwives fulfilling this role, which affected their perceived behavioural control. These included stressful working conditions, too little time, a dearth of educational resources and a lack of knowledge of best practice intervention methods and counselling skills. Perceived patient resistance to quitting was a further obstacle.Key conclusions and implications for practiceFor the intervention to be accepted and adopted by midwives, it would need to offer them an opportunity to enhance their professional knowledge and expertise, provide them with attractive educational aids and take into account the very limited time they have for smoking education. Patient-centred, best practice methods for cessation counselling may help midwives overcome the problem of patient resistance and to engage smokers in constructive discussions about smoking with a greater prospect of success.     

Smoking cessation interventions for pregnant women to prevent low birth weight: what does the evidence show?

PURPOSE: To review the epidemiology of smoking cessation and low birth weight (LBW), the use of meta-analysis and cost-benefit analysis in analyzing this problem, and the financial considerations of institutionalizing smoking cessation interventions. Recommendations for clinicians caring for smoking pregnant women and suggestions for implementing the recommended strategies for smoking cessation programs are included. DATA SOURCES: Comprehensive review of smoking and low birth weight (LBW) outcomes, cost-effectiveness, and tobacco use and dependence literature; clinical practice guidelines, and a widely cited meta-analysis on smoking cessation. CONCLUSIONS: Research has shown that smoking is a significant factor in LBW outcomes and that cessation is especially critical for pregnant women. IMPLICATIONS FOR PRACTICE: Careful evaluation of the intervention research is required before designing local interventions to ensure the most effective measures are utilized.     

Practice nurses' intentions to use clinical guidelines

BACKGROUND: Evidence indicates that, although nurses are increasingly using clinical guidelines to ensure higher quality of care, there is a wide variance in their adherence to them. The utility of the Theory of Planned Behaviour (TPB) has not been previously investigated in explaining this variance in community nursing. AIM: This paper reports a study whose primary aim was to examine the utility of the TPB in explaining variations in practice nurses' intentions to offer smoking cessation advice in accordance with coronary heart disease guidelines. METHODS: A cross-sectional survey using a postal questionnaire was carried out. A 52-item questionnaire was administered to 48 practice nurses in England. The questionnaire was designed to assess the components of the TPB, and included measures of intentions to offer smoking cessation advice, self-reported past behaviour, attitudes, subjective norms, perceived behavioural controls (PBCs), behavioural beliefs and evaluations, normative beliefs and motivation to comply, and control beliefs and evaluations. RESULTS: The TPB explained up to 40% of variance in intentions to offer smoking cessation advice. Attitudes and PBCs were the most important predictors of intention. Among other elements of the TPB, indirect attitudes and indirect PBCs made significant positive contributions to explaining variance in intention. DISCUSSION: Future trials of interventions to increase practice nurses' adherence to clinical guidelines could attempt to address the elements identified in this study as important factors. Further studies are required to examine the utility of the TPB in predicting practice nurses' behaviour.     

Smoking cessation readiness: are your patients ready to quit?

Purpose: To explore the assessment of patient readiness to receive smoking cessation interventions using the transtheoretical model (TTM) and the five stages of change; and to give the primary care provider an evidence-based toolkit to assist in evaluating for readiness and supporting the smoking cessation process.
Data sources: Evidence-based literature, theoretical framework, and peer-reviewed articles.
Conclusions: Utilizing the TTM along with proper training and education of the provider and patient increases the probability that smoking cessation will occur. Combinations of pharmaceutical and nonpharmaceutical interventions are the most effective in smoking cessation.
Implications for practice: Providers can be prepared at every patient visit to address the smoking cessation needs of all patients. The toolkit provided in this article will help facilitate evaluation of readiness and support of effective, long-term smoking cessation and reduce eventual smoking-related morbidities.     

Does physical exercise in addition to a multicomponent smoking cessation program increase abstinence rate and suppress weight gain? An intervention study

Does physical exercise in addition to a multicomponent smoking cessation program increase abstinence rate and suppress weight gain? An intervention study Tobacco use is considered the single most preventable cause of premature morbidity and mortality. Smoking cessation programs aim at two interrelated purposes, to help people to give up smoking and to prevent relapse. A multicomponent intervention consisting of nicotine replacement therapy, health education, behaviour modification therapy and counselling is widely recommended in the health care literature. Smoking cessation studies from a nursing perspective are few. The purpose of this quasi‐experimental study was to compare outcomes of two nurse‐managed 1‐year group smoking cessation interventions. Intervention 1 (n=34) was provided at a health care centre and consisted of nicotine replacement therapy, health education, behavioural modification and individual and group counselling. In intervention 2 (n=33), provided in a health club, physical exercise was added to the intervention provided in 1. Participants were self‐referred with equal numbers in both interventions. A nonsignificant difference in lapse free abstinence time (LFAT) at 1 year was demonstrated between intervention 1 (20.6%, n=7) and intervention 2 (39.4%, n=13) (p=0.16, odds ratio=2.5). The difference in weight gain between intervention groups was also nonsignificant. Within intervention comparison between abstinent participants and smokers showed that abstinent participants had gained significantly more weight than smokers in intervention 2 (p=0.001), but in intervention 1 the difference was nonsignificant (p=0.2). The small sample size in the study detracts from the significance of the findings. However, a trend is observed showing that physical exercise increases the abstinence rate of participants. The conclusion is drawn that a multicomponent smoking cessation program that includes physical exercise might be an effective intervention, but further studies with a larger sample size are needed.     

Multicomponent individualized smoking cessation intervention for patients with lung disease

AIMS: This paper reports a study examining the process and outcomes of a long-term, multicomponent smoking cessation intervention for patients with lung disease initiated while hospitalized and provided over 1-year postdischarge. BACKGROUND: Successful smoking cessation interventions are of primary importance for people with lung disease. Initiation of such an intervention in hospital settings is particularly important as patients may be especially motivated to quit as a result of strong perceptions of vulnerability while hospitalized for a smoking-related disease. Tailoring the intervention to each person's needs is a promising approach to practice. METHODS: All patients who smoked and were admitted to a pulmonary unit over 2 years were invited to participate in this quasi-experimental study (n = 85), and 69 continued beyond the first month. The intervention was shaped by the TransTheoretical Model and used nicotine replacement therapy, along with individual and group counselling and support grounded in the nurse-patient relationship. The intervention was provided during hospitalization and by telephone after discharge at 1 week, and 1, 3, 6 and 12 months. RESULTS: At 12-months postdischarge, 39% of the patients reported continuous abstinence from smoking from the time they joined the programme and 52% were not smoking at that time. No relationship was found between abstinence and the number of quit attempts, readiness to quit, nicotine dependency and length of hospital stay. Readiness to quit had increased and nicotine dependency decreased significantly by the end of the programme. No gender differences were found for the main variables. CONCLUSIONS: Comprehensive, individualized smoking cessation interventions for hospitalized patients having lung disease, with a 1-year follow-up, was successful. Abstinence was high in comparison with other studies. This may in part be explained by significantly enhanced motivation to quit during the smoking cessation programme.     

北京市临床护士实施5A’S戒烟干预的现状调查

目的了解护士在临床工作中实施5A’S戒烟干预的现状,为促进其实施戒烟干预行为提供依据。方法采用方便取样,在北京市城区6家三级医院对230名护士进行问卷调查。问卷主要内容包括：护士实施5A’s戒烟干预的频度及影响因素,护士对自身戒烟干预能力的评价,护士在校期间学习烟草相关知识的情况。结果护士实施5A’s戒烟干预方案中的“建议”和“评估患者的吸烟史及现状”比较频繁,实施其余干预内容的现状均不理想（如评估对尼古丁的依赖程度、提供尼古丁替代疗法的帮助、协助制定戒烟计划等）。“戒烟能改善患者的健康”的信念能促进护士实施戒烟干预,“患者没有戒烟的动机”、“繁重的工作量”、不认为“帮助患者戒烟是护理工作中优先考虑的”,会阻碍护士实施戒烟干预。临床护士对自身进行吸烟危害的健康教育、沟通能力等评价较为理想,但对给予尼古丁替代疗法（NRT）建议和使用一氧化碳检测仪等方面的能力认同较差。护士在校期间学习过的相关内容主要是烟草的危害,且学时有限（1～2h）,很少涉及戒烟技巧、药物疗法等内容,毕业工作后参加过戒烟培训的护士比例也极低（12．8％）。结论临床护士对5A’s戒烟干预的实施、所接受的戒烟相关教育以及实际戒烟干预能力和临床戒烟干预需要之间存在差距。     

Smoking cessation interventions in chronic obstructive pulmonary disease and the role of the family: a systematic literature review

AIM: This paper is a report of a systematic review to assess the effectiveness of family-focused smoking cessation interventions for people with chronic obstructive pulmonary disease and to determine what data on families are documented in studies of smoking cessation interventions. BACKGROUND: Chronic obstructive pulmonary disease is a major public health problem and cigarette smoking is the most important factor contributing to its development and progression. However, smoking cessation rates are low and relapse is common. The role of families in smoking cessation efforts has received little attention. METHODS: All studies were included in the review that (i) addressed an evaluation of a psycho-social/educational smoking cessation intervention for people with chronic obstructive pulmonary disease, (ii) addressed some information on the family (i.e. living arrangements, marital status, smoking history of family members, support for quitting) and/or included the family as part of the intervention and (iii) were published between 1990 and 2006. Electronic data sources, existing systematic reviews of smoking cessation interventions and the grey literature were reviewed. RESULTS: Seven studies were included. Six studies (11 papers) included data on marital status, smoking status of household members, support for quitting smoking and related variables. In two of the studies, the variable on the family was used to analyse smoking cessation outcomes. One additional study met the inclusion criterion of an evaluation of a smoking cessation intervention, which also included a family focus in the intervention. CONCLUSION: No conclusions about the effectiveness of a family-focused smoking cessation intervention could be drawn from this review. Further research is needed to determine if a more family-focused intervention, in conjunction with pharmacological and counselling approaches, would lead to improved smoking cessation outcomes.     

Smoking Cessation and Chronic Pain: Patient and Pain Medicine Physician Attitudes

Although previous studies suggest that the clinical setting of an interdisciplinary pain treatment program may provide an optimal environment to promote smoking cessation, currently available smoking cessation interventions may be less effective for adults with chronic pain due, in part, to unrecognized clinical factors related to chronic pain. The specific aim of this qualitative study was to solicit information from adult smokers with chronic pain participating in an interdisciplinary pain treatment program regarding their perceptions of how smoking affects pain symptoms, and how these beliefs, cognitions, and emotions may either impede or facilitate smoking cessation. Similar information was solicited from a group of pain specialty physicians. The study involved 18 smokers with chronic pain, and seven physicians. Patients reported that smoking was an important coping strategy for pain and distress, primarily by offering an opportunity for distraction and avoidance, respectively. The majority of patients using opioids reported that opioid consumption stimulated smoking. Important barriers were identified toward making a quit attempt during pain treatment including quitting smoking while making changes in opioid use, and perceived difficulty managing multiple treatment‐related stressors. Several pain‐related benefits of smoking cessation were identified by physicians, but important barriers to providing smoking cessation services were recognized including lack of time and knowledge about how to help patients quit smoking. The findings of this study identified several novel and important clinical factors that should be incorporated into a targeted smoking cessation intervention for adults with chronic pain.     

Meeting national tobacco challenges: recommendations for smoking cessation groups

PURPOSE: To review the literature on model smoking cessation programs and provide an overview of the practice guidelines for intensive smoking cessation groups. DATA SOURCES: Selected evidence-based literature and AHCPR/AHRQ clinical practice guidelines. CONCLUSIONS: Smoking is the leading cause of preventable death in our global society and is expected to kill more people than any other disease within 20 years. Data support that most smokers want to quit and are more likely to succeed with a combination of behavioral and pharmacological support. IMPLICATIONS FOR PRACTICE: Smoking cessation must be a priority in the delivery of patient care. Intensive interventions are more effective than brief interventions and should be available for all smokers.     

Partner influences on smoking cessation: A longitudinal study of couple relationships

Introduction: Despite declines in population tobacco use, smoking remains unacceptably high. Smoking cessation may be particularly difficult in couple relationships when partners continue to smoke, and when relationship satisfaction is low. This study examined the longitudinal influence of partner tobacco use and relationship satisfaction on the likelihood of smoking cessation. Methods: Data were obtained from 238 tobacco-using couples aged between 18 and 45 over three assessments from a nationally representative sample of Australian households. Results: There was high concordance between partner smoking six years after the initial assessment, with a little more than three-quarters (76.1%) of non-smokers residing with partners who had also ceased smoking. Step-wise logistic regression models indicated that females were more likely to cease smoking if their partners had previously quit. Males were more likely to quit smoking when they perceived their relationship as highly satisfying and their partner had stopped smoking. Female partners were also more likely to quit smoking when they were highly satisfied with their relationships. Conclusions: Both partner’s smoking status and relationship satisfaction are important considerations in smoking-related cessation. For entrenched smokers in couple relationships, involvement of partners in interventions may be useful.     

Childhood smoking: the research, clinical and theoretical imperative for nursing action

BACKGROUND: Tobacco smoking is a major international health issue which nurses are ideally positioned to address. Childhood represents a critical period for intervention to prevent/reduce smoking. During childhood, the majority of smokers first experiment with smoking, are initiated into the smoking subculture and become addicted to tobacco. Children are highly susceptible to smoking as a result of developmental factors, which promote or facilitate high-risk behaviours, limited coping skills, limited defences and inadequate legal protection against youth-focused marketing of tobacco. AIM: This paper is intended to sensitize nurses to the magnitude of childhood smoking as an international health problem and to familiarize them with current intervention approaches and care issues pertinent to child and adolescent populations. METHOD: An extensive literature review was conducted to determine the impact of childhood smoking at the personal and community level, characteristics of child smokers, the processes associated with smoking cessation, intervention approaches and intervention models for use by nurses across the spectrum of clinical settings. FINDINGS: Evidence exists that behaviourally based interventions by nurses for smoking prevention/cessation are effective with children. Key components of effective behaviourally based antismoking approaches for smokers include addressing self-efficacy to quit, providing social support, resisting temptation to smoke and discussing issues related to relapse and relapse prevention. For all children, the reinforcement of non-smoking behaviour is essential. Intervention models, which can be incorporated into routine clinical care of individual children or with groups, emphasize the importance of parental involvement, routine screening for tobacco use and provision of a clear message that smoking and tobacco use is unhealthy.     

Nurses' opportunistic interventions with patients in relation to smoking

AIM: This paper reports a study exploring nurses' provision of opportunistic health education on smoking for hospital patients. BACKGROUND: Smoking cessation guidelines recommend assessment of patients' smoking habits and provision of smoking cessation advice when possible, and highlight the importance of the role of nurses in health promotion and health education. In the past, nurses have been criticized for lack of knowledge, skills and confidence in relation to health education and the perception that it is additional to, rather than integrated with, nursing care. METHODS: A qualitative case study design was selected to explore the health education practice of 12 nurses working in acute wards in three general hospitals in Scotland. Data were collected in 2000 through non-participant observation, semi-structured interviews and the use of a radio-microphone to record nurse-patient interactions. The data analysis was guided by four key elements of health education practice: 'the teachable moment', 'readiness to learn', 'the provision of health information' and 'oral communication'. FINDINGS: Smoking was part of the nurses' agenda, as most recognized opportunities to introduce health education on smoking during nursing care, suggesting a tentative move towards the integration of health education with nursing care. Evidence from patients' interactions indicated ample opportunity for nurses to provide smoking-related health information. However, the content of nurses' interactions on smoking was variable, with some limited by poor communication skills and inadequate knowledge of smoking and smoking cessation. The context of the interactions was also important in understanding some of the restrictions on conversational progress. CONCLUSIONS: Nurses require the knowledge and skills to perform a health education role, and the inclusion of smoking cessation guidelines in nursing curricula would contribute to this. Where patients are in hospitals for short periods of time, opportunistic health education on smoking needs to be introduced as the basis for more specialist intervention.     

Smoking prevalence, attitudes, and perceived smoking prevention and control responsibilities and practices among nurses in Amman, Jordan

This study assesses smoking prevalence, attitudes, and perceived patient counselling responsibilities among practicing nurses in Amman, Jordan. It also identifies whether their smoking status or training in counselling patients about smoking is associated with their smoking-related attitudes and counselling practices. Data were collected through a cross-sectional survey of 266 (n = 266) nurses at four public and private hospitals in Amman. Smoking prevalence was 42% for male nurses and 13% for female nurses. Nurses strongly favoured enforcement of anti-smoking policy, but did not strongly agree that nurses should be involved in counselling patients about smoking. Approximately 41% of nurses indicated that they had received training on counselling patients about smoking. Nurse training with respect to counselling patients about smoking was positively associated with the nurses' belief that their counselling could help patients stop or never start smoking. In addition, nurses with counselling training about smoking felt significantly better prepared to assist patients to quit smoking. Nurses who smoked were significantly less likely to believe their counselling of patients about smoking could be effective. Finally, smoking status was not significantly associated with how well prepared the nurses felt to assist patients to quit smoking. These findings identify a need for more extensive and better-tailored training programmes for nurses on patient counselling about smoking.