Helping patients stop
smoking
As a nurse, you can help smokers understand that quitting is the
single most effective thing they can do to enhance the quality and
length of their lives. The RNAO Best Practice Guideline,
Integrating Smoking Cessation into Daily Nursing Practice, states
that, depending on the amount of time you have with the patient,
you can provide the appropriate intervention to help them start
along the path of a smoke-free life. The guideline offers a couple
of ways to help patients stop smoking, which are outlined below.
Minimal Intervention
It is essential to provide at least a minimal intervention of 1-
3 minutes in duration to all tobacco users at every appropriate
occasion.
If you routinely give 100 people three minutes of very brief intervention
to quit, two of them will succeed in doing so. Of these two ex-smokers
we can expect that one of them would have been killed by his or
her smoking if he or she had continued.
Thus, a total of two-and-a-half hours work has saved a life. This
makes it a very successful and cost-effective intervention. Smoking
cessation improves health more cheaply than many other medical interventions.
How to Intervene
Set up your practice for three As (Ask, Advise, Assist)
and incorporate the suggested actions and strategies for implementation:
| Ask,
Advise, Assist - Minimal Intervention
|
| Ask |
about tobacco use with all clients (e.g.,
non-smoker, smoker, ex-smoker) and assess readiness to
quit. |
| Advise |
every tobacco user of the importance of
quitting. |
| Assist |
by providing minimal intervention: |
| |
· |
Referral to community resource |
| |
· |
Self-Help Material |
| |
· |
Referral to other health-care provider |
| |
· |
Smokers' Helpline |
| Arrange |
follow-up or referral. |
|
Intensive Intervention
Nurses should introduce intensive intervention of more than 10 minutes
when their knowledge and time lets them. This type of intervention
is appropriate for all smokers willing to participate and is especially
recommended to be offered to “special populations” (pregnant
women, cardiovascular clients, clients with other chemical dependencies
or psychiatrics disorders and various health issues) of smokers.
How to Intervene
Set up your practice for three As (Ask, Advise, Assist)
and incorporate the suggested actions and strategies for implementation:
| Ask,
Advise, Assist - Intensive Intervention
|
| Ask |
about tobacco use with all clients (e.g.,
non-smoker, smoker, ex-smoker) and assess readiness to
quit. |
| Advise |
every tobacco user of the importance of
quitting. |
| Assist |
by providing intensive intervention: |
| |
· |
Determine and discuss the stage of change |
| |
· |
Reasons for smoking (WHY Test) |
| |
· |
Nicotine Dependence (Fagerstrom Test) |
| |
· |
Offer information re: pharmacotherapy options |
| |
· |
Set a quit date |
| |
· |
Review quitting history |
| |
· |
Review potential challenges and triggers, and |
| |
· |
Encourage support of family and friends. |
| Arrange |
follow-up or referral. |
|
This is just an introduction to the smoking cessation principles
found in the Best Practice Guidelines. More detailed information
can be found in these RNAO documents:
Back to Smoking
Cessation
Back to Promoting Health
Back to RNAO Knowledge Depot
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