Smoking cessation during hospital stay: nursing actions and answers
C. Lodewijckx LN, G. Celis RN, A. Schoonis RN, J. De Bent RN, M. Peys RN, V. Lemaigre Psychologist, L. Van Houdenhove Psychologist, K. Nackaerts MD,PhD
Pneumology Division, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium
BACKGROUND
RESULTS (3)**
Hospitalisation, especially for tobacco-related illness:
increases perceived vulnerability and boost receptivity to
smoking cessation interventions
brings smokers in contact with health carers who can
provide a smoking cessation message or intervention
AIMS
To explore:
need of smoking cessations intervention on respiratory wards
nurses’ perceptions among smoking cessation interventions
efficacy of nurse-delivered smoking cessation interventions
RESULTS (1)
Methods: multi-centre descriptive study
Sample: n = 548 patients hospitalised on 12 Belgian
respiratory wards between 17/10/05 – 31/10/05
Results:
smokers: n = 117 (21,9%); ex-smokers: n = 261 (46,8%);
never smokers: n = 170 (31,2%)
378 patients (68,7%) could use our help to quit smoking or stay
abstinent
70%
50%
67,44%
46,8%
45%
60%
willing to quit
40%
50%
35%
33,2%
no answer
31,2%
30%
40%
quit smoking
for 0-6 days
all patients
25%29% 21,9%
30%
20%
18,6%
24%
15,5%
15%
20%
10%
6,4%
10%5%
0%0%
not willing to quit
quit smoking for 7-30 days
men
13,6% 16,85% 12,6%
6,13%
5,36%
4,21%
smokers
Smokers
ex-smokers
never-smokers
Ex-smokers
quit smoking for 1-6 months
women
quit smoking for 6 months-1
year
quit smoking for >1 year
Fig.1: Smoking status in 548 patients hospitalised on 12 respiratory Belgian
wards (10 different hospitals)
• Rigotti et al. (2003): meta-analyses of 29 studies; any
type of health care setting
Review
• Schultz et al. (2003): overview of 10 studies (6 RCT’s);
nurse-delivered hospital based interventions
n=54 (14,5%)
Fig. 2: Nurse-delivered smoking
cessation intervention
• significantly increase of quitting with nursing intervention
Fig. 3: Nursing smoking cessation congres
03/12/2005 Ostend Belgium
n=199 (53,5%)
Results
RESULTS (2)**
Perceptions among smoking cessation interventions:
hospitalisation is an ideal time for patients to quit
smoking
smoking cessation is an important part of the nursing
role
Mean reasons for NOT providing smoking cessation:
patient-related: lack of motivation, privacy, condition
nurse-related: lack of knowledge, lack of skills and
confidence, lack of time
Tobacco use among nurses:
prevalence: 7% - 46%
perception of smokers in nurses among smoking
cessation intervention:
▪ less enthusiastic
▪ less confidence in skills and efficacy
• more intensive intervention is not significantly more
successful
• patients seems to be more receptive for smoking
cessation interventions during hospital stay
Tabel 1: Effectiveness of nurse-delivered smoking cessation interventions
CONCLUSIONS
At least 25% of patients hospitalised on respiratory wards
could use help in quitting smoking or staying abstinent
Strong evidence for effectiveness of nurse-led smoking
cessation intervention
Nurses perceive smoking cessation as an important part of
their role, but need more skills and knowledge
CHALLENGES
Integration of tobacco dependence treatment into standard
nursing practice
Nursing education among smoking cessation interventions
Support for tobacco dependent nurses
Support (financial, resources) from government and hospital
management
** References available by the author: [email protected]