Nursing Tobacco Interventions -- Part I
Goal:

The learner will be able to screen for tobacco use in adolescent and adult patients and provide basic motivational and behavioral tobacco interventions. This module focuses on interventions for patients who are not ready to quit tobacco.

: 0.75 hrs

After completing this activity participants will be able to:

  • Screen patients for tobacco use

  • Provide brief counseling interventions for patients who are not ready to quit tobacco

  • Use motivational interviewing skills when counseling patients in tobacco interventions


Professional Practice GapsTobacco use is still fairly common; in the United States. Approximately 28.4% of persons aged 12 or older used a tobacco product in the last month in a 2008 survey (NSDUH, 2009). Tobacco is estimated to be responsible for 443,000 premature deaths annually (CDCP, 2008) and cause significant morbidity (Surgeon General, 2004). The effectiveness of tobacco interventions by health care providers was evaluated in a review of the literature by the review panel for the U.S. Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update (Fiore, et al., 2008). They found that medication and counseling are more effective for promoting tobacco cessation than no treatment and that intervention effectiveness increases with increased intervention intensity. The Clinical Practice Guideline (Fiore, et al., 2008), also provided evidence-based guidelines for clinicians on how to provide brief and more extensive interventions in tobacco use. Despite the documented need for tobacco cessation and effectiveness of clinical interventions and availability of practice guidelines, many health providers still are not providing evidence-based tobacco interventions. A number of studies have found that screening for tobacco use and recommending cessation occurs as frequently as 75% of the time in primary care, other appropriate tobacco interventions are made by in primary care less frequently (Schnoll R et al, 2004; Braun et al, 2004; Jaen et al, 2001; Ellerbeck et al, 2001). Training health care professionals in evidence-based, brief tobacco interventions in order to assure that all health providers know and are confident to provide tobacco interventions will help address this practice gap. References
Braun B, Fowles J, Kind E, Lando H, Pine D. Smoking-related attitudes and clinical practices of medical personnel in Minnesota. American Journal of Preventive Medecine. 2004; 27(4): 316-322.
Ellerbeck EF, Ahluwalia JS, Jolicoeur DG, Gladden J, Mosier MC. Direct observation of smoking cessation activities in primary care practice. J Fam Pract. 2001; 50(8): 688-93. Available at: https://www.ncbi.nlm.nih.gov/pubmed/11509163 Accessed on: 2014-07-28.
Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008. Available at: https://www.ncbi.nlm.nih.gov/books/NBK63952/ Accessed on: 2013-09-26.
Jaen CR, McIlvain H, Phillips RL, Flocke S, Crabtree BF. Tailoring tobacco counseling to the competing demands in the clinical encounter. Journal of Family Practice. 2001; 50(10): .
National Center for Chronic Disease Prevention and Health Promotion. Targeting tobacco use: the nation's leading cause of death, at-a-glance. CDC Web site. 2010. Available at: https://stacks.cdc.gov/view/cdc/5527 Accessed on: 2016-09-06.
Schnoll R, Rukstalis M, Wileyto E, Shields A. Smoking cessation treatment by primary care physicians: An update and call for training. American Journal of Preventive Medicine. 2006; 31(3): 233-239.
Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2008 National Survey on Drug Use and Health: National Findings. Office of Applied Studies, NSDUH Series H-36, DHHS Publication SMA 09-4434 . 2009. Available at: http://archive.samhsa.gov/data/NSDUH/2k8nsduh/2k8Results.htm Accessed on: 2010-10-29.