Commentary on Sarna L, Bialous SA, Wells M, Kotlerman J, Wewers ME & Froelicher ES (2009) Frequency of nurses’ smoking cessation interventions: report from a national survey. Journal of Clinical Nursing 18, 2066–2077

Abstract

Current estimates suggest that cigarette smoking causes the premature deaths of 5,000,000 people per year globally (Mathers & Loncar 2006) and in developed countries alone accounts for two million deaths per year (Peto et al. 2006). Preventing young people from starting to smoke would be effective at reducing this figure, but would not be significant until after 2050 (BMJ 2000 Anonymous). Strategies aimed at smoking cessation are necessary to reduce tobacco related mortality in the medium term (BMJ 2000 Anonymous). This commentary centres on a study by Sarna et al. (2009) investigating hospital nursing smoking cessation intervention measures in the USA. The study is of particular relevance to those of us in other regions who are also struggling with the global epidemic of long term health conditions, many of which are strongly associated with cigarette smoking. This paper returns to some of the findings of the Sarna study and reflects upon their increasing relevance to the role of acute nurses on the public’s health. Nearly 23% of men and 21% of women in England smoke (General household survey 2007). Most smokers in countries such as the UK and the USA report that they want to stop and intend to stop at some point (Aveyard & West 2007). The rate of attempts at stopping is high (78 attempts per 100 smokers per year in the UK), with many smokers making several efforts in a year (The Office for National statistics (ONS) 2007). Nearly half of all smokers expect not to be smoking within the year but only 2–3% each year actually stop permanently (ONS 2007). Current approaches to smoking cessation recognise that cigarette smoking is not a simple habit, but a complex physiologic addiction that requires a multi-facated intervention scheme from a variety of sources in order to encourage lifestyle change. As Sarna et al. (2009) explain, just such an approach is being facilitated in the USA and involves Government funded resources, including the national telephone quitting helpline, which has been shown to increase quit rates. Other countries have also adopted, wholly or partially, the World Health Organization (WHO) framework convention on tobacco control. In England, the Government has established a comprehensive National Health Service (NHS) stop smoking service providing counselling, support, nicotine replacement therapy and pharmacological assistance on prescription for those who wish to quit. The Department of Health funded research (DOH 2005) show that about 15% of people using government funded assistance remain non-smokers at 52 weeks and, when compared to no formal intervention, are up to four times as likely to succeed. These initiatives have cost £112 million over the past two years (DOH 2008) which equates to £173 per person in 2007/08, an increase of eight per cent from 2006/07and there appears to be commitment to continue with this support in the foreseeable future. This appears to be a significant amount, although the WHO point out that generally governments spend less than one-fifth of 1% of the money collected in tobacco taxes each year on tobacco control activities (WHO 2007). However, it appears that current cessation support resources exist within an atmosphere of increasing recognition by the UK government that they wish to share responsibility of smoking cessation by