Nurses are in a key position to influence their patient's choices and promote smoking cessation.
Using tobacco remains one of the biggest killers, causing early death in over half of its users and much often unseen suffering from co-morbidities. Many community nurses see this on a daily basis and have a pivotal role in health promotion for their patients and their families. Smoking harms nearly every organ of the body and drastically reduces quality of life. Currently in the UK, approximately 18% of the population smoke tobacco and in certain populations it is much higher. For example, 60% to 70% of people with severe mental health problems smoke and mortality rates are three to four times higher than the general population (depending on where in the UK they live).
Practice nurses and community teams are often at the forefront of caring for patients with smoking related disease but also the general public. The starting point to helping is a simple question; do you smoke? Smokers expect this question and every time it is not asked it reinforces thinking quitting is not a priority. Many nurses would be surprised that 70% of smokers would like to quit and therefore this should make brief intervention advice less scary.
I have found it easier to integrate brief intervention advice into my normal consultation time as an advanced nurse practitioner in an out of hour’s service by linking to symptoms or condition. For example, stopping smoking improves healing by 20%.
‘The best thing for your health is to stop smoking and there is support available, I would like to help’ is how I usually introduce it.
Practice nurses are fundamental to delivering a full smoking cessation service and training is available from local stop smoking services.
A full smoking cessation service should comprise of twelve weeks of behavioural support and a course of medication (such as a combination of nicotine replacement therapy or tablets (usually varenicline or bupropion). This should be available in a range of settings for example GP Practices and pharmacists and well as community groups and in hospitals recommended by NICE. Unfortunately, many services are being cut due to the local government funding crisis which is in my opinion a big problem and needs to be addressed. The practice and community nurse will find it difficult to give health promotion advise such as ‘stopping smoking will help to reduce your blood pressure’ if then they are unable to offer smoking cessation to facilitate this.
I would encourage all nurses to complete brief intervention advice training, which can take as little as 20 minutes online and integrate this into their daily practice. You only need to help a handful of patients to save a life; no other intervention has such a powerful outcome.
Wendy Preston, nurse consultant and
non-medical prescribing lead, George Eliot Hospital, Nuneaton