Prevention: tobacco control and cancer nursing

Prevalence and risk factors of adolescents smoking: difference between korean and korean-chinese

PURPOSE

The purpose of this study was to compare smoking prevalence and risk factors of smoking between Korean and Korean-Chinese middle school students.

METHODS

Data was collected from seventh and eighth grade students from 12 schools in Korea and 6 schools in China. Descriptive statistics, Chi-square test, and t test were performed.

RESULTS

For data analysis 10,002 usable surveys were utilized. The smoking prevalence was higher in Korean-Chinese students than in Korean students. Risk factors, such as father smoking, friends smoking, gender, grade, academic achievement, alcohol use, and family income were associated with current smoking, and the differences in the two samples were significant. Korean-Chinese students were more likely than Korean students to have friends who smoked and a father who smoked. Smokers had a significantly higher rate of friends smoking, father smoking, and alcohol use. Korean-Chinese male students smoking prevalence was more than three times higher than Korean students. Korean students could sense a more anti-tobacco atmosphere in their environment. Korean-Chinese students were more likely than Korean students to perceive that it was easy to buy cigarettes and to smoke cigarettes in a public computer room.

CONCLUSION

These results highlight the differences of smoking prevalence and risk factors between Korean-Chinese students and Korean students. The findings may help health educators and researchers to better understand adolescent smoking and risk factors cross culturally and aid in the development of more effective education programs, which could lead to preventing tobacco use among these populations.

Are nurses prepared to curb the tobacco epidemic in China? A questionnaire survey of schools of nursing

BACKGROUND

Smoking prevalence among Chinese males is the highest in the world and its morbidity and mortality is growing. Previous studies suggested nurses are inadequately prepared to treat tobacco use and dependence.

OBJECTIVES

To examine the inclusion and organization of tobacco control content in the undergraduate nursing curriculum of Hong Kong and Mainland China; and the smoking status of faculty and students.

DESIGN

Cross-sectional survey.

METHODS

Deans of 32 nursing schools in Hong Kong and China with an undergraduate programme (representing over 12000 students) completed a self-administered questionnaire.

RESULTS

Most schools included the health hazards of tobacco (56.3-100%), but few covered tobacco cessation theory (31.3-62.5%), or behavioural (9.4-56.3%) and pharmacological (3.1-34.4%) interventions in the curriculum. Most curricula covered less than 1h of tobacco content per year of study. Nearly all schools (93.1%) reported smoking among faculty but only half reported access to smoking cessation programmes.

CONCLUSIONS

This is the first known study to examine the extent of tobacco control education in the nursing curriculum in China. Results suggested deficiencies in the coverage and clinical practice in smoking and smoking cessation, and recommendations were made to strengthen the curriculum.

Barriers and challenges for tobacco control in a smoke-free hospital

The study aimed to identify the extent of smoking, compliance with tobacco restrictions, and attitudes toward smoking and tobacco control measures among the employees in a Comprehensive Cancer Center from 2001 to 2006 where a smoke-free policy was progressively introduced. Four cross-sectional surveys were conducted from 2001 to 2006. Survey items include smoking status, smoking history, environmental tobacco exposure, and agreement with tobacco initiatives. The prevalence of smoking has declined from 34.5% in 2001 to 30.6% in 2006. The decrease was present in all professional groups: Doctors from 20.0% in 2001 to 15.2% in 2006 and administrative clerks from 56.0% in 2001 to 37.0% in 2006 reduced the most. Among nurses, the prevalence of smoking was still high with a 2-point percent reduction (from 34.0% in 2004 to 32.6% in 2006). Other changes of the pattern of smoking were apparent: a reduction on the number of cigarettes smoked, decrease of daily smokers, and increase of smoking abstinence during the hospital duty. Compliance with smoke-free areas increased. We observed a very significant decrease of the perception of exposure to environmental tobacco exposure at work. The Smoke Free project helped to achieve a healthy work environment. Tailored smoking cessation programs should be designed to help healthcare professionals to stop smoking. In addition, healthcare professionals should play a key role in promoting a healthy smoke-free lifestyle.

Clinical Implications of Smoking and Aging: Breaking Through the Barriers

In the United States, there are almost 4 million smokers older than 65. Yet, older smokers often receive suboptimal care. Inaccurate information and myths about older smokers may have become ingrained in the attitudes and beliefs of both older smokers and health care providers. In this article, prominent myths about older smokers will be explored and refuted. The realities include the following: Smoking tobacco has no benefit; it does not improve cognition or mood; smoking cessation, even among older, frail adults, produces significant benefits in terms of health and quality of life; and using filtered cigarettes or reducing the number of cigarettes smoked per day does not reduce harm. Gerontological nurses are at the forefront of treating tobacco use among older smokers. They should assess the smoking status of all older adults at every contact, treat smokers with pharmacotherapy and counseling, follow up with patients, and stay informed.

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.

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.

Tobacco and its trendy alternatives: implications for pediatric nurses

Although acute and critical care pediatric nurses may not rank tobacco prevention and cessation among their top patient-care priorities, the importance of providing health education, especially during vulnerable moments, cannot be overlooked. This article provides an overview of trendy tobacco alternatives, such as bidis, clove cigarettes, hookah pipes, and smokeless tobacco, that entice youth. The significant health consequences of these tobacco products and the implications for pediatric acute and critical care nursing practice are also discussed.

Tobacco control policies

OBJECTIVES

To review and summarize tobacco control policies, their impact in curbing the tobacco epidemic, and to describe a role for nursing advocacy.

DATA SOURCES

Published articles and research studies.

CONCLUSION

Comprehensive tobacco control policy is one of the most effective mechanisms to prevent tobacco-related cancers and other illnesses. The World Health Organization's Framework Convention on Tobacco Control, and the Master Settlement Agreement in the United States have provided new opportunities for tobacco control. Nursing participation in the policy process can expand and strengthen these policies' activities.

IMPLICATIONS FOR NURSING PRACTICE

Involvement in tobacco control should be integral to oncology nursing efforts to prevent cancer, promote health, and quality of life.

International efforts in tobacco control

OBJECTIVES

To review international nursing involvement in tobacco control and discuss opportunities and challenges to enhance nurses' participation in decreasing tobacco-related morbidity and mortality.

DATA SOURCES

Published literature and published and unpublished material developed by nurses in their tobacco control initiatives.

CONCLUSION

Worldwide, nurses have been involved in tobacco control. However, many opportunities remain for involvement in the areas of education, research, and practice.

IMPLICATIONS FOR NURSING PRACTICE

There are numerous opportunities for nurses throughout the world to enhance their involvement in tobacco control.

Nursing and tobacco reduction: a review of the literature

Nurses have an instrumental role to play in tobacco reduction, which is one strategy used to address tobacco use; a primary source of preventable morbidity and mortality globally. The following review addresses activities by two groups of nurses: nursing governance bodies and nurse scientists, whom together provide vision and knowledge to support and shape nursing practice. While nursing governance bodies and scientists have contributed a great deal to tobacco reduction, there are also gaps. Areas that require strengthening are: support for tobacco dependent nurses, basic nursing education concerning tobacco dependency treatment, and integration of tobacco dependence treatment into nursing practice.

Tobacco Dependence Curricula in Acute Care Nurse Practitioner Education

• Background Tobacco dependence is the leading preventable cause of death in the United States, yet healthcare professionals are not adequately educated on how to help patients break the deadly cycle of tobacco dependence.

• Objective To assess the content and extent of tobacco education in the curricula of acute care nurse practitioner programs in the United States.

• Methods A survey with 13 multiple-choice items was distributed to the coordinators of 72 acute care nurse practitioner programs. The survey was replicated and modified from previous research on tobacco dependence curricula in undergraduate medical education.

• Results Fifty programs (83%) responded to the survey. Overall, during an entire course of study, 70% of the respondents reported that only between 1 and 3 hours of content on tobacco dependence was covered. Seventy-eight percent reported that students were not required to teach smoking-cessation techniques to patients, and 94% did not provide opportunities for students to be certified as smoking-cessation counselors. Sixty percent reported that the national guidelines for smoking cessation were not used as a curriculum reference for tobacco content.

• Conclusions The majority of acute care nurse practitioner programs include brief tobacco education. More in-depth coverage is required to reduce tobacco dependence. Acute care nurse practitioners are in a prime position to intervene with tobacco dependence, especially when patients are recovering from life-threatening events. National recommendations for core tobacco curricula and inclusion of tobacco questions on board examinations should be developed and implemented.

Smoking and health: opinions and awareness among general dentists in Jordan

AIM

To examine dentists' awareness on major health risks associated with smoking and their opinions on factors that influence tobacco use.

DESIGN

A pre-tested postal questionnaire survey.

PARTICIPANTS

A randomly selected sample of 849 licensed general dentists who were practicing dentistry in Jordan.

RESULTS

A response rate of 72.2% (613/849) was obtained. The majority of respondents (91.8%) related lung cancer to smoking, however, associations with other cancers (cancer of oesophagus, pancreas and urinary bladder) were the least reported (33.6%). Only 39% agreed that smoking is the most important cause of premature death, non-smokers were significantly more likely to believe in this than current smokers. Most dentists associated tobacco use with staining of teeth (97.2%), whereas fewer dentists reported that smokers have increased risks of oral cancer (83.7%) and potentially malignant oral lesions (76.7%). Friends and stress were the most frequently implicated factors in the habit of smoking.

CONCLUSION

This study revealed a significant lack of awareness among Jordanian dentists with respect to serious health consequences of smoking. An educational programme targeted towards general dentists in Jordan is needed, focusing attention on tobacco related morbidity and mortality.

Nurses' competence in advising and supporting clients to cease smoking: a survey among Finnish nurses

The article describes the results of a survey of Finnish nurses (n = 882). The purpose of the study was to describe how nurses' education, working experience and their own smoking habits relate to their self-reported competence in advising and supporting clients to cease smoking. Nurses evaluated their skills fairly highly, but did not believe that advice alone was helpful to clients who wished to cease smoking. Nurses had minimal knowledge of smoking substitutes. Lower general education, a fairly short time from graduation and a history of smoking were positively related to nurses' competence to guide clients. Nurses who smoked daily were found to have better skills in giving advice and support than their non-smoking colleagues. The results have implications for the design of smoking cessation programmes. More education and guidance is required for nurses, so that they can develop their understanding and a positive view as to the effectiveness of smoking cessation programmes.