Impact of a web-based educational program on Japanese nurses tobacco cessation practice and attitudes in oncology settings.

PURPOSE: To evaluate the effects of a short web-based educational program on Japanese nurses' self-reported attitudes toward tobacco cessation and their use of interventions to help smokers to quit. DESIGN: Prospective, single-group design with a pre-educational survey, a short web-based educational program, and a follow-up survey at 3 months. METHODS: Clinical nurses were asked to view two prerecorded webcasts about helping smokers quit. They completed two online surveys, one at baseline and one at a 3-month follow-up. Generalized linear models were used to determine changes in nurses' self-reported routine practice after the study intervention. FINDINGS: A total of 1401 nurses responded to the baseline survey, 678 of whom completed the follow-up survey. Compared with baseline, nurses at follow-up were more likely to advise smokers to quit (odds ratio [OR] = 1.45, 95% confidence interval [CI: 1.15, 1.82]), assess patients' interest in quitting (OR = 1.46, 95% CI [1.01, 1.04]), and assist patients with smoking cessation (OR = 1.34, 95% CI [1.04, 1.72]). However, the proportion of nurses who consistently recommended resources for tobacco cessation did not significantly improve at follow-up. CONCLUSIONS: This study provides preliminary evidence that a web-based educational program can increase nurses' implementation of tobacco dependence interventions in cancer care practice. Sustaining these educational efforts could increase nurses' involvement in providing these interventions, encourage nurses to refer patients to cessation resources, and support nurses' attitudes towards their role in smoking cessation. CLINICAL RELEVANCE: Our short web-based educational program can increase nurses' use of tobacco-dependence interventions in cancer care practice. This role can be enhanced with additional information about existing cessation resources that nurses could use to refer patients for support post-discharge. Japanese nurses, when properly educated, are willing and significant contributors to promote tobacco use cessation for cancer patients. The contribution can be facilitated through nursing care protocol that integrate tobacco use cessation interventions within evidence-based cancer care approaches.

Building capacity in tobacco control by establishing the Eastern Europe Nurses' Center of Excellence for Tobacco Control.

INTRODUCTION: Properly educated nurses delivering evidence-based tobacco dependence treatment could contribute to improving health and reducing regional disparities in tobacco-related disease and death in Central and Eastern Europe. The aims of this study are to describe development of the Eastern European Nurses' Centre of Excellence for Tobacco Control (COE) and evaluate its online educational program on tobacco dependence treatment using the 5As framework. METHODS: The online education evaluation followed a prospective, single group, pre- and post-assessment of changes in nurses' self-reported tobacco cessation interventions. Leaders from five Eastern European countries (Hungary, Czech Republic, Romania, Slovakia, Slovenia) developed protocols for in-country tobacco control education. Nurses responded to a baseline survey, accessed an online nursing educational program, and completed a follow-up survey at 3 months, in the period December 2015 to June 2016. A total of 695 nurses from five countries answered questions on cessation interventions at baseline and of these 507 (73%) completed a follow-up survey at 3 months. RESULTS: At the follow-up at 3 months, the 507 nurses self-reported a significant increase in providing all 5A components, i.e. nurses were significantly (p<0.0001) more likely to always /usually advise a patient to quit, assess interest in quitting (p=0.002), assist with a quit plan, review barriers to quitting and recommend a smoke-free home post-discharge (all p<0.0001). They were also significantly more likely (p=0.01) to agree or strongly agree that nurses have an obligation to advise patients on the risks of smoking. There was a significant increase (p<0.0001) in nurses' estimate of the number of patients they provided a cessation intervention the previous week. Nurses who smoked were 60% more likely to assist and arrange compared to nurses who never smoked. CONCLUSIONS: Coordinating multi-country activities through a COE was successful in engaging a network of nurses to use an online educational program and participate in other tobacco control activities.

"Everyone Needs a Breath of Fresh Air": Workplace Impact on Nurses' Smoking Behaviors.

BACKGROUND: Europe continues to have among the highest worldwide prevalence of adult smoking (28%) and the highest among females (19%). Nurses' rates of smoking in the region are comparable or higher than the general female population. Nurses who smoke are less likely to intervene with patients who smoke; therefore, supporting nurses' efforts to quit is critical to promoting nurses' well-being and strengthening the profession's impact on prevention of tobacco-induced diseases. OBJECTIVE: The aim of this study was to explore nurses' perceptions of hospital workplace factors that influence nurses' smoking and quitting behaviors in Central and Eastern Europe. METHODS: Each country had a project director involved in the recruitment of participants and the translation of instruments. Using a moderator guide, focus groups (N = 9) about smoking and quitting were conducted in 5 countries (Czech Republic, Hungary, Romania, Slovakia, Slovenia) among 82 nurses who self-reported as current or former smokers. Recorded transcripts were translated and analyzed using content analysis methods. RESULTS: The majority of nurses were female (94%) and currently smoking (65%). Four major themes were identified that describe workplace factors influencing nurses' smoking behaviors and efforts to quit: (1) taking breaks, (2) effect of smoking on patient interactions, (3) perceived collegial support for quitting, and (4) impact of workplace policies. CONCLUSIONS: Workplace factors influence nurses smoking and quitting behaviors. IMPLICATIONS FOR PRACTICE: Changes in healthcare systems and policies are needed to support nurses' quit efforts. Additional education is needed to ensure that nurses understand issues related to smoking and interactions with patients.

Attitudes, barriers and facilitators to smoking cessation among Central and Eastern European nurses: A focus group study.

PURPOSE: Smoking among nurses is a barrier to providing smoking cessation interventions to patients. In Central and Eastern Europe-where tobacco use is the leading cause of preventable death and disease-there is limited knowledge about nurses' attitudes toward cessation interventions. Our aim was to describe the attitudes of nurses who are former and current smokers toward providing cessation interventions to patients as well as explore barriers and facilitators to their own quit efforts. METHODS: Nine focus groups with 81 nurses (94% females) in five Central and Eastern European countries. Content analysis was used to identify major themes. RESULTS: Nurses agreed that they should set a good example by not smoking; should be involved in helping patients stop smoking; and needed additional training in tobacco control. Five common themes were identified as barriers to quitting: smoking cues in the environment; presence of smokers in the environment; relapse postpartum; stress and nicotine addiction; and misperceptions about the dangers of smoking. Former smokers reported facilitators to quitting including: seeing the health consequences of smoking among their patients; personal and family health concerns; receiving support from family; and pregnancy. CONCLUSION: 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. Future studies should focus on programs that support nurses' quit efforts by addressing barriers to smoking cessation, which will improve their health and patient care.

Impact of a webcast on nurses' delivery of tobacco dependence treatment.

AIMS AND OBJECTIVES: To evaluate an educational programme about nurses' role in tobacco dependence treatment, and its webcast component, on the long-term impact of increasing the frequency of nurses' self-reported changes in practice related to delivery of smoking cessation interventions. BACKGROUND: Healthcare professionals' knowledge about evidence-based tobacco dependence treatment using the 5As framework (Ask about tobacco use, Advise users to quit, Assess willingness to quit, Assist in making a quit plan and Arrange for follow-up, including referral to a quitline) is essential to increase smoking cessation rates in the United States. DESIGN: A 6-month pre-post design. METHODS: A convenience sample of nurses (N = 283) from Kentucky and Louisiana was provided access to the webcast and printed toolkit. Responses from those who completed an online survey at baseline, and at 3 or 6 months postimplementation of the educational programme were included in an analysis of changes in the consistent (always/usually) delivery of the 5As plus referral to the quitline. RESULTS: After 3 months, the intervention had a significant impact on increasing nurses' reports of consistently providing the 5As to patients who smoked, which was largely sustained at 6 months. Nurses who viewed the webcast were three times more likely to refer smokers to a quitline at 3 months; and four times more likely at 6 months than those who did not. CONCLUSIONS: An online educational programme, plus printed toolkit about tobacco dependence treatment increased nurses' delivery of smoking cessation interventions over time. This study provided preliminary evidence that including a webcast in a nurse-targeted educational programme could significantly increase the proportion of nurses who referred smokers to a quitline beyond the benefit of access to printed materials and web-based resources. RELEVANCE TO CLINICAL PRACTICE: Distance learning is a feasible mechanism for enhancing nurses' involvement in tobacco dependence treatment and promoting evidence-based clinical practice.

Impact of Online Education on Nurses' Delivery of Smoking Cessation Interventions With Implications for Evidence-Based Practice.

BACKGROUND: Tobacco use is the leading cause of preventable disease and death in Europe and worldwide. Nurses, if properly educated, can contribute to decreasing the burden of tobacco use in the region by helping smokers quit smoking. AIMS: To assess: (a) the feasibility of an online program to educate nurses in Czech Republic and Poland on evidence-based smoking cessation interventions for patients and (b) self-reported changes in practices related to consistently (usually or always) providing smoking cessation interventions to smokers, before and 3 months after participation in the program. METHODS: A prospective single-group pre-post design. RESULTS: A total of 280 nurses from Czech Republic and 156 from Poland completed baseline and follow-up surveys. At 3 months, nurses were significantly more likely to provide smoking cessation interventions to patients who smoke and refer patients for cessation services (p < .01). Nurses significantly improved their views about the importance of nursing involvement in tobacco control. IMPLICATIONS FOR PRACTICE: Education about tobacco control can make a difference in clinical practice, but ongoing support is needed to maintain these changes. Health system changes can also facilitate the expectation that delivering evidence-based smoking cessation interventions should be routine nursing care. LINKING EVIDENCE TO ACTION: Educating nurses on cessation interventions and tobacco control is pivotal to decrease tobacco-related disparities, disease, and death. Online methods provide an accessible way to reach a large number of nurses.

Nurses' Attitudes toward Intervening with Smokers: Their Knowledge, Opinion and E-Learning Impact.

BACKGROUND: Numbering about 90,000, nurses represent the largest group of health care providers in the Czech Republic. Therefore, nurses can make a significant impact in the treatment of tobacco dependence, particularly in applying brief interventions to smokers. METHODS: During 2014, 279 nurses from the Czech Republic participated in an e-learning education programme consisting of two Webcasts with additional web-based resources about smoking cessation in relation to health and treatment options in daily clinical practice, particularly regarding brief intervention methods. Before viewing the e-learning programme, and three months after viewing it, the nurses completed a questionnaire documenting their interventions with smokers and their knowledge, attitudes and opinions regarding nurses' roles in smoking cessation. RESULTS: The responses in all of the following categories significantly improved: usually/always asking patients about smoking from 58% to 69% (OR 1.62, CI=1.14-2.29, p=0.007); recommendations to stop smoking from 56% to 66% (OR 1.46, CI=1.03-2.06, p=0.03); assessing willingness to quit from 49% to 63% (OR 1.72, CI=1.23-2.42, p=0.002); assisting with cessation from 21% to 33% (OR 1.85, CI=1.26-2.71, p=0.002); and recommending a smoke-free home from 39% to 58% (OR 2.16, CI=1.54-3.04, p<0.001). The increase in arranging follow-up from 7% to 10% did not constitute a statistically significant improvement, however, this finding is understandable in relation to the status of nurses in the Czech Republic. However, nurses' confidence in helping smokers to quit smoking, their senses of responsibility and determining the appropriateness of these interventions remains inadequate. CONCLUSION: The nurses' brief intervention skills improved significantly after the completion of the e-learning programme, even though reservations remain among this group. The systematic education of nurses aimed at smoking cessation intervention and analyzing their motivation for treatment may contribute to improved nursing care, and thus lead to a reduction of smoking prevalence in the general population.

Helping smokers quit: behaviours and attitudes of Chinese Registered Nurses.

AIMS: To describe the self-reported frequency of Chinese nurses' interventions to help smokers quit, using the 5 As (i.e. Ask, Advise, Assess, Assist, Arrange), attitudes towards tobacco control and differences in consistency interventions by demographic and professional characteristics prior to an educational intervention to increase nurses' support for quit efforts. BACKGROUND: Tobacco use is the leading cause of preventable death in China; quitting smoking reduces health risks and premature death. The China Tobacco Cessation Treatment Guideline supports the 5 As model for intervention, but nurses' frequency of delivering smoking cessation interventions is unknown. DESIGN: Descriptive survey using a convenience sample. METHODS: Nurses from eight hospitals in Beijing and Hefei, China completed a web-based survey in 2012. Differences in consistency of the 5 As by nurse characteristics were determined using multivariate logistic regression. Overall importance of nurses in tobacco control was evaluated on a 1-5 scale (5 = most important). RESULTS: Nurses (N = 2440; 1404 Beijing, 1036 Hefei) participated. 64% consistently asked about smoking status, 85% advised patients to quit, 52% assessed readiness to quit and assisted with smoking cessation and 17% arranged for follow-up. Interventions varied by nurses' education and clinical setting. Nurses positively viewed involvement in tobacco control (4·3/5) and thought nurses should be smoke-free role models (4·8/5·0). CONCLUSIONS: This study demonstrates that the majority of nurses asked about smoking status, but few assisted patients with quitting. Further efforts are needed to help nurses actively promote smoking cessation interventions.

Evaluation of a web-based educational programme on changes in frequency of nurses' interventions to help smokers quit and reduce second-hand smoke exposure in China.

AIMS: To evaluate a web-based educational smoking cessation programme on changes in the frequency of hospital-based nurses' self-reported interventions to help smokers quit using the 5 As (i.e. Ask, Advise, Assess, Assist, Arrange), to reduce exposure to second-hand smoke and to change attitudes about nurses' involvement in tobacco control. BACKGROUND: Few nurses in China support smokers' quit attempts using evidence-based smoking cessation interventions based on the 5 As. Limited knowledge is a barrier to intervention. Web-based tobacco cessation programs have the potential to reach a large population of nurses. DESIGN: A prospective single-group design with pre-, 3- and 6-month follow-up after the educational programme evaluated the feasibility of conducting web-based educational programs in two cities in China in 2012-2013. METHODS: Frequency of interventions was assessed using a valid and reliable web-based survey with a convenience sample of nurses from eight hospitals in Beijing and Hefei, China. Generalized linear models, adjusting for age, clinical setting, education and site were used to determine changes in the consistent (usually/always) use of the 5 As from baseline to 3 and to 6 months. RESULTS: Nurses (N = 1386) had baseline and/or 3- and 6-month data. At 6 months, nurses were significantly more likely to Assess, Assist and Arrange for smoking cessation and recommend smoke-free home environments. There was significant improvement in attitudes about tobacco control. CONCLUSIONS: Nurses receiving web-based smoking cessation education significantly increased self-reports of frequency of providing interventions to patients who smoke, including recommending smoke-free home environments to support quit attempts.

Tobacco Cessation Practices and Attitudes Among Nurses in the Czech Republic.

BACKGROUND: Tobacco is the leading cause of cancer in the Czech Republic. More than one-third of the population older than 15 years smokes, including many nurses. Most smokers want to quit, but the extent of nurses' involvement in tobacco cessation is unknown. OBJECTIVE: The purposes of this study are to describe the frequency of nurses' interventions in helping smokers quit, examine their attitudes and skills, and explore the relationship of nurses' smoking status to level of intervention. METHODS: A convenience sample of nurses in the Czech Republic completed a survey about their frequency of interventions according to the 5As for tobacco dependence treatment (i.e., ask, advise, assess, assist, arrange), their attitudes and perceived skills, and their smoking status (never, former, current). RESULTS: A total of 157 nurses completed the survey; 26% "always" or "usually" assisted patients with smoking cessation. Few (22%) reported that nurses could play an important role in helping patients quit, and 65% rated their ability to help smokers quit as "fair/poor." Nurse who smoked (30%) were less likely to consistently assess smoking status or arrange for follow-up support. CONCLUSION: Few nurses in the Czech Republic consistently provide smoking cessation support to patients, have the skills to do so, or view this role as an important part of their role. IMPLICATIONS FOR PRACTICE: To reduce tobacco-related cancers in the Czech Republic, capacity-building efforts are needed to enhance nurses' skills and confidence in providing smoking cessation interventions. Support is also need to help nurses who smoke quit.

Impact of a smoking cessation educational program on nurses' interventions.

PURPOSE: To evaluate a brief educational program about smoking cessation on the frequency of nurses' interventions with smokers, and impact of nurses' smoking status on outcomes. DESIGN: Prospective, single group design with prestudy and 3 months post-study data. METHODS: Nurses in the Czech Republic attended hospital-based 1-hr educational programs about helping smokers quit. They completed surveys about the frequency (i.e., always, usually, sometimes, rarely, never) of their smoking cessation interventions with patients using the five A's framework (i.e., ask, advise, assess, assist, arrange), and their attitudes prior to and 3 months after the course. Demographic data included smoking status. FINDINGS: Among the 98 nurses with prestudy and post-study data, all were female, mean age was 43 years, 33% were current smokers, and 64% worked in a medical or surgical or oncology settings. At 3 months, compared to baseline, significantly (p < .05) more nurses assessed patients' interest in quitting, assisted with quit attempts, and recommended the use of the quitline for cessation. At 3 months after the program, nurses who smoked were less likely to ask about smoking status (odds ratio [OR] = 4.24, 95% confidence interval [CI; 1.71, 10.53]), advise smokers to quit (OR = 3.03, 95% CI [1.24,7.45]), and refer patients to a quitline (OR = 2.92, 95% CI [0.99, 8.63]) compared to nonsmokers, despite no differences in delivery of interventions at baseline. CONCLUSIONS: Three months after attendance at an educational program focused on the nurses' role in supporting smoking cessation efforts, more nurses engaged in interventions to help smokers quit. However, the program was less effective for nurses who smoked. CLINICAL RELEVANCE: This program demonstrated promise in building capacity among Czech nurses to assist with smoking cessation, but nurses' smoking poses a challenge.

Increasing nursing referral to telephone quitlines for smoking cessation using a web-based program.

BACKGROUND: Smokers who make a quit attempt during hospitalization have improved long-term abstinence if they receive follow-up support, including via a telephone quitline, a free resource in the United States. Smokers are referred infrequently to this resource by healthcare providers. OBJECTIVE: The aim of this study was to evaluate the impact of a Web-based educational program (Helping Smokers Quit) on translating the Treating Tobacco Use and Dependence Clinical Practice Guideline: 2008 Update into practice. Using a Web-based survey, frequency of nurses' self-reported referral of smokers to a quitline and performance of the components of a smoking cessation intervention (the 5As: Ask, Advise, Assess, Assist, Arrange) was compared with self-reported performance among nurses who received printed educational materials (control group) at 6 months. METHODS: Nurses from 30 (n = 15 control and n = 15 intervention) randomly selected and assigned hospitals from California, Indiana, and West Virginia participated. Both groups received a toolkit of materials including a state quitline card and access to the Tobacco Free Nurses Web site; the intervention group had additional access to a project-specific Web page and the opportunity to attend a webinar. Only nurses who completed baseline and 6-month surveys were included in the analysis. Mean improvement of the 5As and refer scores and logistic regressions of consistent (usually or always) referral to a quitline were used to examine differences over time by group. RESULTS: Pre-post data were collected for 333 nurses (209 intervention, 124 control). Mean improvement was significantly higher in Advise, Assess, Assist, Arrange, and Referral to a Quitline for the Help Smokers Quit group. Nurses in the control group significantly improved in Advise and Referral to a Quitline. Consistent referral was most likely in the intervention group (OR = 1.74, 95% CI [1.11, 2.72]), especially among those who viewed the webinar (OR = 2.34, 95% CI [1.03, 4.23]). DISCUSSION: After 6 months, nurses in the intervention group had significant improvement in the frequency of interventions and consistency of referral of smokers to the quitline. The improvement of nurses' referral to the quitline among the control group who only received printed materials demonstrates that both are effective strategies in increasing awareness of this resource.

Nurses' treatment of tobacco dependence in hospitalized smokers in three states.

Hospital-based nurses (N = 1,790) from three states reported their interventions to help patients quit smoking. Frequency of nurses' interventions in one low tobacco use state, California (n = 651), were compared to nurses' interventions in two high tobacco use states, Indiana (n = 720) and West Virginia (n = 419). Nurses in California were significantly more likely to Advise smokers to quit (OR 1.34, 95% CI [1.06, 1.69]) and Refer smokers to a Quitline (OR 2.82, 95% CI [1.36, 5.88]) compared with nurses in the high tobacco prevalence states. Other aspects of their interventions did not differ by state. Quitline referral was infrequent (16%) but was quadrupled if nurses arranged for smokers to quit (OR 4.07, 95% CI [3.11, 5.32]).

Nurses trying to quit smoking using the Internet.

Nurses QuitNet, an Internet-based smoking cessation program, was created to support nurses' quit attempts. The purposes of this study were to evaluate quit attempts at 3, 6, and 12 months after the use of the program and to determine differences in demographic, professional, and smoking characteristics by smoking status. Differences in the use of quit methods, barriers, and facilitators to quitting also were assessed. Data among 246 smokers who responded to at least 1 follow-up email at 3, 6, or 12 months after registration were analyzed. Quit rates among respondents were 43% (3 months), 45% (6 months), and 53% (12 months). Total time on the website was significantly higher for those who quit. Barriers to quitting included lack of support from colleagues, stress, lack of cessation services, and fear of not getting a work-break. Facilitators included working in a smoke-free facility, support from colleagues, and workplace cessation services. The use of Nurses QuitNet demonstrated promise in supporting quit attempts. Quitting was influenced by workplace factors.

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.

Do you need to smoke to get a break?: smoking status and missed work breaks among staff nurses.

INTRODUCTION: The prevalence of missed work breaks by smoking status in healthcare settings is unknown. The work routines of nurses (Registered Nurses [RNs] and Licensed Practical Nurses [LPNs]), who smoke at higher rates than other health professionals, may be influenced by smokers who use breaks to avoid nicotine withdrawal. The purpose of this study was to examine the relationship between nurses' smoking status and work breaks and to explore the relationships among personal, professional, and workplace variables associated with missed work breaks. METHODS: A web-based survey of 2589 staff nurses from 34 hospitals was conducted in 2006. Each hospital had been designated as a Magnet hospital by the American Nurses Credentialing Center. Data analysis included descriptive statistics, chi-square tests, and multivariate logistic regression. RESULTS: The majority (90%) were nonsmokers; 97% were RNs. Missed breaks were common (70%) and differed by smoking status: 59% of smokers and 72% of nonsmokers frequently missed work breaks. Multivariate logistic regression determined that nonsmokers (OR=1.81, 95% CI=1.36, 2.42), LPNs (OR=2.37, 95% CI=1.16, 4.84), older nurses (OR 1.02, 95% CI=1.01, 1.03), those in emergency rooms (OR=1.75, 95% CI=1.25, 2.47), and in intensive care units (OR=1.60, 95% CI=1.22, 2.09) were more likely to miss breaks. CONCLUSIONS: Missed work breaks were common among nurses. Those who did not smoke were almost twice as likely to miss their work breaks as compared to smokers. Inequities in breaks, especially by smoking status, may cause dissension in the workplace and negatively affect patient care. Policies that support work breaks for all nurses are needed.

Characteristics of nurses who used the Internet-based nurses QuitNet for smoking cessation.

BACKGROUND: Smoking among nurses is higher than other health care professionals but nurse-specific cessation programs are limited. Nurses QuitNet, launched in January 2004, provided an evidence-based online smoking cessation program for nurses and nursing students. OBJECTIVES: To describe Nurses QuitNet registrants and relationships among the demographic and smoking characteristics, program dissemination strategies, and site utilization patterns. DESIGN: Cross-sectional study. SAMPLE: 1,790 Nurses QuitNets registrants. MEASUREMENTS: Demographics and smoking characteristics on the Nurses QuitNet intake questionnaire. RESULTS: Most registrants were female (92.5%), 45-54 years old (34.3%), Caucasian (84.5%), and college graduates (57.5%). Over 68% smoked 10-20 cigarettes/day; 66.4% smoked within 30 min of waking. Half of those with previous quit attempts did not use evidence-based methods; 30% had not made a quit attempt in the past year. "Read-only" social support was the most frequently used Nurses Quitnet feature. CONCLUSIONS: The Internet can be a viable option to support nurses' cessation and is available to accommodate their work schedules. The sample is similar to the general nursing population, except for higher levels of education. Efforts are needed to assist nurses struggling with nicotine addiction and disseminate cessation resources, particularly targeting nurses with the highest prevalence of current smoking, for example licensed practical nurses.

Smoking among psychiatric nurses: does it hinder tobacco dependence treatment?

BACKGROUND: Data on tobacco dependence treatment for patients with mental illness are limited. OBJECTIVE: Describe factors associated with psychiatric nurses' tobacco interventions. STUDY DESIGN: Survey of 100 psychiatric nurses. RESULTS: The majority "always/usually" asked (87%), advised (70%), and assessed (74%) tobacco use. A minority (49%) assisted with quit attempts, and arranged (21%) for follow-up. Former (56%, odds ratio [OR] = 0.13, 95% confidence interval [CI] = 0.02, 0.88) and current smokers (20%, OR = .08, 95% CI = 0.01, 0.72) were less likely to ask about tobacco use than never smokers. CONCLUSIONS: Efforts are needed to promote tobacco cessation and to support nurses who smoke to quit.

Use of complementary and alternative medicine therapies to control symptoms in women living with lung cancer.

Complementary and alternative medicine (CAM) use by cancer patients, especially women, is increasing. However, CAM use among patients with lung cancer, who have been reported to have the highest symptom burden, is poorly documented. This study describes types and frequencies of specific CAM therapies used by women with lung cancer to manage symptoms, and examines differences in demographic and clinical characteristics between CAM users and non-CAM users. Participants included 189 women with non-small cell lung cancer and > or =1 of 8 symptoms. Six CAM therapies, used to control symptoms, were assessed, including herbs, tea, acupuncture, massage, meditation, and prayer. Forty-four percent (84 women) used CAM therapies, including prayer (34.9%), meditation (11.6%), tea (11.6%), herbs (9.0%), massage (6.9%), and acupuncture (2.6%). Complementary and alternative medicine use was greatest for difficulty breathing and pain (54.8% each), with prayer the most commonly used CAM for all symptoms. Significant differences (P < .05) were found for age (t = 2.24), symptom frequency (t = -3.02), and geographic location (chi = 7.51). Women who were younger, experienced more symptoms, and lived on the West Coast or South (vs Northeast) were more likely to use CAM. We found that CAM use is variable by symptom and may be an indicator of symptom burden. Our results provide important initial data regarding CAM use for managing symptoms by women with lung cancer.

Nursing research in smoking cessation: a listing of the literature, 1996-2005.

A listing of publications related to nurses and tobacco is posted on the Tobacco Free Nurses Web site (www.tobaccofreenurses.org). For this conference, a chronological listing of the numbers and type of data-based articles that focused on nursing involvement in tobacco cessation published since 1996, the year of the first publication of the Agency for Health Care Policy and Research, Clinical Practice Guideline #18, through 2005 was developed. One hundred and seventy-five data-based papers that met the criteria, that is, the paper focused on smoking cessation and involved nurses, were identified. Most (88%) articles were exclusively focused on cessation. Research designs included experimental (38%), quasi-experimental (24%), descriptive-quantitative (25%), descriptive-qualitative (8%), meta-analyses (2%), and secondary analyses and systematic reviews (each 1%). The number of articles that focused on nursing involvement in tobacco cessation has increased eight fold in the past 10 years, from less than 5 articles published in 1996 to more than 40 published in 2005. The minority (35%) of data-based articles that focused on nurses and tobacco cessation were published in nursing journals.