Impact of tobacco control auxiliary resources on the 5As behavior in nursing interns: Self-reports from students

Study on the participation of nursing staff in tobacco cessation support and related influencing factors: A survey from Chongqing, China

INTRODUCTION

Nursing staff's assistance for smokers to quit smoking can increase the rate of quitting. The smoking cessation help can be affected by many factors. This study surveyed the use of the 5As (Asking, Advising, Assessing, Assisting, Arranging) approach to support smoking cessation by the nursing staff in Chongqing, China, and analyzed the corresponding influencing factors.

METHODS

A stratified random cluster sampling method was used to select nursing staff from 8 tertiary hospitals, 5 secondary hospitals, 12 community health centers, and 35 township health centers in different geographical regions of Chongqing. A questionnaire survey was conducted among the nursing staff to investigate their participation in smoking cessation. Binary logistic regression analysis was employed to analyze the influencing factors of smoking cessation 5As behavior of the nursing staff.

RESULTS

The 1669 participants were 44 males (2.6%) and 1625 females (97.4%), with an average age of 37.00 ± 10.89 years. Among the participants, 55.2% were from tertiary hospitals, 23.2% from secondary hospitals, 14.2% from township health centers, and 7.4 from community health centers. The often or always used behaviors were: Asking, 69.2%; Advising, 53.0%; Assessing, 39.5%; Assisting, 33.7%; and Arranging, 25.1%. The factors that affected all the 5As were: smoking cessation training (AOR=1.60; 95% CI: 1.22-2.11), knowledge of smoking cessation guidelines (AOR=1.75; 95% CI: 1.32-2.32) and the use of smoking cessation Apps (AOR=1.50; 95% CI: 1.09-2.06), and smokers' willingness to quit (AOR=2.20; 95% CI: 1.60-3.02).

CONCLUSIONS

Smoker's motivation to quit smoking and nurses' knowledge of tobacco cessation resources affected nurses' participation in smoking control behavior. While encouraging smokers to quit smoking, clinical nursing staff should be provided with related resources to advocate smoking cessation. Guided by the Chinese Clinical Tobacco Cessation Guidelines, smoking control knowledge and skills training should be provided for nursing staff to increase their positive attitude towards smoking control, so as to promote their active participation.

Status and correlates of children's exposure to secondhand smoke at home: A survey in Chongqing, China

INTRODUCTION

The home is the primary source of children's exposure to secondhand smoke. This study investigated the status and influencing factors of child exposure to secondhand smoke at home when people smoke in the household.

METHODS

Participants with at least one child living in their household from 10 communities in Chongqing were recruited and provided a self-administered questionnaire using a multistage proportional random sampling design from June to August 2021. The chi-squared test and binary logistic regression analyses were used to identify influencing factors.

RESULTS

The questionnaire completed by 1345 families showed that 631 (46.9%) families lived with smokers in their household, and 509 (80.7%) of those families reported that smoking occurred within the home while the children were present. Binary logistic regression analyses demonstrated that the time between waking up and household smokers having the first cigarette of the day (OR=0.44; 95% CI: 0.22-0.85), changes to smoking habits and behaviors within the last six months (OR=1.76; 95% CI: 1.06-2.90), attitudes towards tobacco control in the household (OR=2.91; 95% CI: 1.72-4.92), self-efficacy in maintaining a smoke-free home (OR=2.27; 95% CI: 1.36-3.79), having rules to maintain a smoke-free home (OR=3.25; 95% CI: 1.68-6.29), and the status of providing cigarettes to guests at home (OR=11.0; 95% CI: 1.33-90.8) were associated with exposure to SHS.

CONCLUSIONS

Education focusing on the impact of smoking on children's health should be encouraged. Smoke-free homes should be established, and smoking restrictions in the household should be enacted. Therefore, information about the available tobacco-control services should be given to family members and be used properly. It is an effective way to decrease the risk of at-home exposure to SHS for children, to overcome any obstacles in tobacco control.

Status and correlates of home smoking bans after the implementation of the smoke-free legislation in public places: A survey in Chongqing

INTRODUCTION

Secondhand smoke exposure in many countries decreased dramatically after the implementation of smoke-free legislation in public places, but the exposure at home did not change to the same degree. The aim of this study was to describe the status and correlates of a home smoking ban in Chongqing, China.

METHODS

From June to August 2021, we selected two healthcare centers in the East, West, North, South and Middle regions of Chongqing. We investigated the family smoke-free situation in the selected region using a stratified random sampling method. A chi-squared test was performed to compare the totally and partially smoke-free homes, and a binary logistic regression model was used to analyze the correlates of smoke-free rules at home.

RESULTS

The study investigated 2121 families, among which 884 (41.7%) implemented a total ban on smoking at home. The covariates included age (OR=1.54; 95% CI: 1.18–2.01), living with children aged <14 years (OR=1.51; 95% CI: 1.20–1.90), no smokers in the family (OR=2.37; 95% CI: 1.78–3.17), awareness of the hazards of secondhand smoke (OR=1.30; 95% CI: 1.07–1.59), worrying about the impact of smoking in the presence of children on health (OR=1.92; 95% CI: 1.25–2.95), no difficulty (OR=1.34; 95% CI: 1.07–1.67) and confidence (OR=1.73; 95% CI: 1.41–2.13) in stopping others from smoking, no smoking rules in cars (OR=3.67; 95% CI: 2.58–5.22), and frequency of entertaining guests with cigarettes (OR=0.41; 95% CI: 0.28–0.59).

CONCLUSIONS

It is common for households in Chongqing to have smoking bans, especially those with children. If a family has members that are smokers, education researchers should pay more attention to the hazards of secondhand smoke on the health of family members, and to adopt more tobacco control measures and enhance the self-efficacy of implementing a home smoking ban. Helping smokers to quit is a vital way to decrease the hazards of cigarettes.

Impact of tobacco cessation education on behaviors of nursing undergraduates in helping smokers to quit smoking

INTRODUCTION

Smoking continues to be a significant public health issue, but nursing students do not receive sufficient training on tobacco cessation education. Integrating the 5As behaviors for tobacco cessation into a compulsory course could improve nursing students’ skills and increase their clinical behaviors for assisting patients in quitting smoking. The aim of this study was to evaluate the impact of evidence-based tobacco cessation education on the perceptions and behaviors of nursing students who are assisting patients to quit smoking.

METHODS

A prospective single-group design was used to evaluate the perceptions and behaviors of 626 senior nursing students enrolled in an education program, at three time points: baseline, 3 months post education, and 6 months post education. Data were collected, before and after the tobacco cessation education, using assessment tools for knowledge, attitudes, and the 5As behaviors for assisting patients to quit smoking.

RESULTS

A total of 572 senior students completed the baseline survey, 289 students completed the survey 3 months post education, 348 students completed the survey 6 months post education, and 285 students completed all three surveys. Knowledge and self-efficacy of tobacco cessation were improved dramatically (p<0.05) after the education program, compared with the baseline survey. At 6 months post education, compared with at 3 months post education, nursing students reported more interventions of asking, advising, assessing, assisting, and arranging smokers to quit smoking (p<0.05).

CONCLUSIONS

The integration of tobacco cessation education into compulsory courses could improve clinical skills and enhance the behaviors of nursing students for assisting patients to quit smoking.