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Submit your questions related to smoking cessation practice:

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How many nurses smoke?
  1. What percentage of nurses are smokers?
  2. What is the efficacy rate for RNAO Best Practices for Brief Intervention and Minimal Intervention?
I will tell you what we know, and more importantly, what we don’t know yet!

First, regarding how many nurses smoke. From everything I can find, there has been very little published research on this issue. There is an American statistic that indicates 15% of nurses smoke (National Cancer Institute, 2005, unpublished data). If this holds true in Canada, it is lower than the general population smoking prevalence of 19%, but obviously a concern for many reasons.

Physicians, for instance, are reported to have a smoking prevalence of about 3.3%. Fortunately, we do have information about how effective tobacco interventions by health care providers can be. It is important that health care providers have the training to do the interventions in order to get the results described here. The following information is from the meta-analysis done for the American Clinical Practice Guideline 2000 (page 58).

We know that with no intervention, smokers will spontaneously quit at a rate of 10.9%. After one year, the median quit rate with minimal counseling (<3 min) is 13.4%; Low intensity counseling (3-10 Min) is 16.0%; and higher intensity counseling (>10 min) is 22.1%. Please note that it isn’t really the exact percentage that is important. It is the trend.

According to this information, the more intensive the intervention, the better the quit rate. Furthermore, whatever we do, the quit rate will be doubled if the patient uses pharmaceutical aides such as the Nicotine Replacement Therapies (i.e., patch, gum, or inhaler), or medications such as Bupropion SR (Zyban) or Varenicline (Champix).

Interestingly though, are the results of a recent meta-analysis done by Wewers, M.E., Sarna, L., and Hill, V., 2005 published in Nursing Research Journal July/August 2006. In their article they state that: “ Smokers that were offered advice by a nursing professional had an increased likelihood of quitting by approximately 50% compared to smokers without nursing intervention.” With their study, there was no significant difference between interventions classified as high intensity compared with low intensity.

Based on these published documents then, we are safe to say that tobacco interventions with patients are very important, whether they be brief interventions with provision of self-help materials or more ongoing, intensive interventions including counseling and/or telephone follow-up. We need to do whatever fits into our work setting.