Harmful Effects Of Tobacco Use Research Articles

National Survey of Smoking and Smoking Cessation Education Within UK Midwifery School Curricula.

Smoking in pregnancy in the United Kingdom remains prevalent (11%). To encourage and support pregnant smokers to quit, midwives must be adequately trained to do so. Substantial curricular gaps have been identified in the smoking cessation training of medical, nursing, and optometry schools. This study aimed to identify the extent of smoking cessation training and assessment in UK midwifery schools. All UK undergraduate midwifery schools (n = 53) were invited to complete a web-based survey of their curricular coverage and assessment related to smoking cessation, and perceived barriers to delivering smoking cessation training. Twenty-nine (55%) midwifery schools responded. Most teaching was completed in the initial year of study. All reported teaching the harmful effects of tobacco use. The majority of respondents (83%) reported training students in brief intervention delivery and ways to assist quit attempts. Only 24% of schools in this study included relapse prevention in their curriculum. The most frequently reported barriers to teaching smoking cessation were "lack of knowledge amongst staff" (17%), "no space in a crowded curriculum" (17%), and "administrative problems" (13%). Midwifery schools are teaching the harmful effects of smoking and providing training on brief interventions. However, in some schools student midwives are not being sufficiently trained on relapse prevention or assessed in the practical skills necessary for delivering evidence-based interventions. Midwifery schools should revise the content and delivery of smoking cessation training to ensure midwives are equipped with the necessary knowledge and skills to contribute to the challenge of smoking cessation in pregnancy.

Tobacco-You are never too Old to Quit

Tobacco has been a part of affluent society since centuries, and now this social status has gradually become a stigma. The awareness about the harmful effects of tobacco use has drastically increased in recent decades. Quitting though obstacle by dependence has never been a challenge with a self determination, good counseling and medication. Though the health benefits are greater for people who stop at earlier ages, there are benefits at any age.

Tobacco Use Among Long Route Bus Drivers and Staffs of Dharan Eastern Nepal a KAP Study

Tobacco use remains a major cause of preventable deaths worldwide. WHO estimated that about 25% of Nepalese population smokes. In Nepal it is widely believed that tobacco use among bus drivers and staffs is very high. This descriptive cross sectional study was conducted in Dharan bus station among 300 bus drivers and staffs who voluntarily responded with self-administered questionnaire to estimate the prevalence of tobacco consumption and to assess their knowledge, attitude and practice regarding tobacco use. Prevalence of tobacco consumption among the respondents was 96.3%. Tobacco initiation at the age <18 years was 52%. ‘Peer pressure’ and ‘Influenced by family member(s)’ were the reasons for initiation while ‘Like the intoxicated feeling’ (67.5%) and ‘Feeling Mature’ for continued use. Respondents (97%) claimed they knew about the injurious effect of tobacco use, diseases cited being respiratory, cancer and cardiac, but only 48.9% knew this before initiating its use. A 75.8% of tobacco consumers had tried to quit it due to ‘Health issue’ (65.3%) followed by ‘Pressure from family member/s’ and ‘Economic burden’. Only about 20% were successful in quitting. The main reason for failure was feeling of addiction (69.7%). Among current tobacco users, 95% would like to seek medical help in quitting, if available. Our study concluded that the prevalence of tobacco consumption among bus drivers and staffs was very high. More than half started its use at age <18 years without prior knowledge of harmful effects of tobacco use. Majority would like to seek medical help as they have failed quitting it due to feeling of addiction. Targeted programs such as nicotine replacement clinics would be highly effective for them with desire to quit tobacco use with medical help.

Tobacco-You are never too Old to Quit

Tobacco has been a part of affluent society since centuries, and now this social status has gradually become a stigma. The awareness about the harmful effects of tobacco use has drastically increased in recent decades. Quitting though obstacle by dependence has never been a challenge with a self determination, good counseling and medication. Though the health benefits are greater for people who stop at earlier ages, there are benefits at any age.

Do cigarette health warning labels comply with requirements: A 14-country study

The Framework Convention on Tobacco Control, a global health treaty ratified by over 175 countries, calls on countries to ensure that tobacco packages carry health warning labels (HWLs) describing the harmful effects of tobacco use. We assessed the extent of compliance with 14 countries' HWL requirements. Unique cigarette packs were purchased in 2013 using a systematic protocol in 12 distinct neighborhoods within three of the ten most populous cities in the 14 low- and middle-income countries with the greatest number (count) of smokers. HWL compliance codebooks were developed for each country based on the details of country-specific HWL requirements, with up to four common compliance indicators assessed for each country (location, size, label elements, text size). Packs (n=1859) were double coded for compliance. Compliance was examined by country and pack characteristics, including parent company and brand family. Overall, 72% of coded cigarette packs were compliant with all relevant compliance indicators, ranging from 17% in the Philippines to 94% in Mexico. Compliance was highest for location of the warning (ranging from 75%–100%) and lowest for warning size (ranging from 46%–99%). Compliance was higher for packs bought in high SES neighborhoods, and varied by parent company and brand family. This multi-country study found at least one pack in every country – and many packs in some countries – that were not compliant with key requirements for health warning labels in the country of purchase. Non-compliance may be exacerbating health disparities. Tobacco companies should be held accountable for complying with country HWL requirements.

A Study to Assess the Awareness of Ill Effects of Tobacco among Adolescents and Young Adults of Mangalore

Abstract Introduction: Tobacco use among school children is becoming a serious problem in developing countries. The early age of initiation underscores the urgent need to intervene and protect this vulnerable group from falling prey to this addiction. Tobacco use is a leading cause of preventable deaths world over, more so in developing countries. The tobacco situation in India is unique because of a vast spectrum of tobacco products available for smoking as well as smokeless use. Aims and Objectives: To assess the awareness of risk factors and consequences of tobacco use among adolescent and young adults. Materials and Method: Materials used are - Questionnaire pertaining to the awareness of smoking. Methodology: Assessment of awareness and knowledge of tobacco smoking was done by means of answering a pretested validated questionnaire with annonimity. Results: According to the study 78.23% said that they were aware of effects of smoking on health.39.83% and 14.78% thought it would lead to lung disease and heart disease respectively. 7.8% of the smokers were aware that smoking leads to cancer Conclusion: According to the study, 78.23% of the study sample were aware of harmful effects of tobacco use on health.

Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey.

This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control.

PM026 Sensitization of Health Students in the Three Eco-Epidemiological Zones in Ghana on the Harmful Effects of Tobacco Use and Tobacco Industry Interference

PM026 Sensitization of Health Students in the Three Eco-Epidemiological Zones in Ghana on the Harmful Effects of Tobacco Use and Tobacco Industry Interference

Prevalence and Dependency of Tobacco Use in an Indigenous Population of Kerala, India

Background: Kerala has a large number of tribal communities where the prevalence of tobacco related oral mucosal lesions is alarmingly high. This coupled with ignorance regarding harmful effects of tobacco use is an emerging public health problem. Purpose: To find out dependency of tobacco use in an indigenous population of Wayanad, India. Methods: A cross- sectional study was designed in the tribal colonies of Kalpetta, Kerala. A multi-stage cluster sampling design was adopted to select the indigenous people living in colonies. A structured close-ended interview was conducted using a 27-item questionnaire, modified and adapted from the National Institute for Mental Health and Neurosciences, India (NIMHANS). The questionnaire consisted of five domains. To assess the dependency of tobacco habit, Fagerstrom Nicotine Dependency Scale for both smoking and smokeless forms of tobacco were used. Results: Of the 103 responses obtained, 41.7% were males. Participants were in the age group of 14-70 years with a mean age of 43 years. Almost half of the respondents cleaned their teeth twice daily. About 53% of people cleaned their teeth using fingers. Toothpowder and rice husks were the commonly used materials for cleaning teeth (64%) followed by toothpaste (35.9%). It was observed that the prevalence of tobacco use in this population was 73.8%. Majority of the respondents (92%) used smokeless forms of tobacco. The mean scores of nicotine dependency for smoked tobacco was 3.85 (± 2.7) and that for smokeless form was 4.61 (± 2.17). Both these scores denote moderate dependency of tobacco use. The average age of onset of tobacco use was 16.41 years for smoked and 17.53 years for smokeless forms. Conclusions: The prevalence of tobacco consumption was found to be high among both males and females in the tribal population. Majority of them consumed different forms of smokeless tobacco

Tobacco Cessation is a Panacea for Good Oral Health

Tobacco use is responsible for lots of diseases which deteriorate general health as well as oral health. Tobacco is a risk factor for most of the diseases affecting each and every organ of the body. Its effects on oral health include oral cancers, periodontitis, impaired wound healing, increased risk of anomalies etc. Tobacco cessation can reverse these harmful effects of tobacco use. Tobacco cessation results in better tissue response, increased blood flow, better response to treatments and reduced risk of cancers etc. Thus tobacco cessation is a panacea for good oral health. Dental/Oral health professionals are pivotal in providing tobacco cessation services to their patients. World Health Organisation has also started Global Oral Health Programme which recommends dental/oral health professionals to provide cessation services. Unfortunately data from across the globe including India suggest that very few dental practitioners provide cessation advise/help as a routine to their patients. Various barriers have been identified and solution to these barriers has also been suggested in this review article. It has been concluded in this paper that good oral health to patients could only be provided by including tobacco cessation services as a part of dental/oral health practice.

Has the attitude of school students toward smoking changed after a decade since the framework convention of tobacco control?

Sir, Nearly 6 million people die globally due to tobacco use and more than 63% of all deaths due to non-communicable diseases (NCDs) are related to tobacco use.[1] The WHO Framework Convention on Tobacco Control (WHO FCTC) is an international treaty adopted by the World Health Assembly on 21 May 2003. The WHO FCTC was developed in response to the globalization of the tobacco epidemic.[2] WHO introduced the MPOWER measures which are intended to assist in the country-level implementation of effective interventions to reduce the demand for tobacco, contained in the WHO FCTC.[3] India is one the signatories of the WHO FCTC and also has introduced many of the intervention measures suggested by FCTC which include Cigarettes and Other Tobacco Products Act, 2003 (COTPA)[4] and National Tobacco Control Program.[5] We intended to study the perception and attitude of school students toward tobacco use after a decade of efforts against tobacco use. A cross-sectional study was done between January and March 2012 in one of the higher secondary schools of rural Puducherry. Five schools in rural area within a 20-km radius from JIPMER were approached and only one school consented to participate in the study. The school was a private, English medium school with over 1000 students. There were a total of 233 students belonging to 8th, 9th and 10th(age group 13-15 years as included in Global Youth Tobacco Surveys) class. We included all the students who were present on the day of survey (N = 200) in the school from these three classes. Informed consent from the Principal of the school and Institutional Ethics Committee clearance was obtained for the study. On the survey day, the students were made to assemble in a hall and the Global Youth Tobacco Survey Core questionnaire (GYTS core questionnaire) was distributed to them. As the school's medium of education was English, the questionnaire was provided in English. Confidentiality and anonymity of the data collected were assured. Adequate time was provided for completion of the questionnaire. Data were analysed using SPSS (Statistical package for Social Sciences) version 16. All proportions were reported as percentages. Of the 200 students, 183 returned complete data collection forms and hence only they were included for analysis. Girls constituted 58.5% (107) of the study population. It was found that current use of tobacco in any form was seen in 12.6% of the students (Boys: 23.7%; Girls: 4.7%). Current use of smokeless form of tobacco was found among 6.6% of the students (Boys: 11.8%; Girls: 2.8%). Just more than half of the students (53.6%) felt that cigarette smoking is definitely harmful to health (Boys: 56.6%; Girls: 51.4%). The rest were not too sure and said that it may probably be harmful or harmless. The proportion of students who felt that second hand smoke was definitely harmful was found to be only 41% (Boys: 38.2%; Girls: 43%). A higher proportion of girls (76.6%) said that they would not smoke a cigarette in the next 5 years when compared to boys (51.3%). Only a very small proportion (<10%) of the students felt that smoking would result in more friends or make a person more attractive or comfortable at social gatherings. However, at least one-fourth of the students felt that smoking status made no difference in the number of friends one would have or in the attractiveness of an individual [Table 1].Table 1: Attitude toward tobacco use among students of a school in rural PuducherryTherefore, 10 years after WHO FCTC, the prevalence of tobacco use is similar to the national average studied in 2006.[6] Even after a decade of interventions, a section of the students have still not grasped the harmful effects of tobacco use and have a neutral attitude toward smoking and smokers. Hence efforts toward tobacco control needs to be revisited. Thank You.

Smoking cessation education and training in UK nursing schools: A national survey

Smoking remains the leading cause of preventable, premature death in the UK. Very Brief Advice (VBA) from Health Care Professionals (HCP) can trigger quit attempts, and behavioural support from trained practitioners can assist with these quit attempts. The purpose of the current study was to assess the self-reported content of smoking cessation education, and extent of training, in pre-registration nursing schools in the UK. Seventy-one UK nursing schools were invited to complete a web-based survey that measured smoking cessation content and training on nursing curricula. Thirty-two (45%) nursing schools responded to the survey. Almost all schools (91%) reported including the harmful effects of tobacco use on their curriculum, however only around half of schools reported teaching nicotine addiction and its treatment. Just under two-thirds of schools (66%) reported providing training to deliver brief interventions to smokers. Over a third of schools (38%) reported spending under three hours teaching smoking cessation throughout the entire programme. Only 6% of schools reported examining students on what they had been taught. Lack of knowledge amongst staff and uncertainty about who should deliver the teaching was reported as barriers to teaching. Gaps in UK nursing curricula, including training in smoking cessation interventions and in examining what has been taught, are likely contributing to the less than optimum smoking cessation interventions delivered by UK nurses in practice.

Tobacco use among teenagers in Ludhiana, Punjab, India: A survey of initiation, prevalence, knowledge, and attitude

Introduction: Tobacco use among school going children is becoming a serious public health issue in developing countries like India. According to the study conducted by S.K. Jindal in 2004, in the northern states of India, prevalence of tobacco use was lowest in Punjab because smoking is strongly against the Sikh tenets. However, a recognizable change in trends has been observed recently. Aim: To determine the prevalence of tobacco use, the age of initiation, factors leading to initiation, and the knowledge about the health hazards caused by tobacco use among adolescents in the city of Ludhiana, Punjab. Materials and Methods: A cross sectional study was conducted among 400 adolescents between the ages of 13 to 19 years in Ludhiana using a self-administered questionnaire. Result: In all, 12.75% of the students were found to be tobacco users. The age of initiation was around 15 years. Majority of the students were initiated into this habit by friends or by immediate family members. In total, 78.64% of the students reported to be aware of the harmful effects of tobacco use. Conclusion: This study demonstrated a relatively high prevalence of tobacco use among adolescents in Ludhiana, Punjab. Peer pressure was the main factor in the initiation of this habit. Strict laws need to be passed and interventions designed to reduce the use of tobacco among adolescents.

Determinants of tobacco use and perception, attitude about an antitobacco act in rural Haryana, North India

Background: Tobacco use is one of the most important preventable causes of morbidity and mortality in India. It is essential to study perception, practices and factors determining tobacco use to formulate the intervention for addressing this problem in the community. Materials and Methods: A cross-sectional study was carried out in 28 villages in Ballabgarh block of Faridabad, Haryana. This study aimed to understand factors determining tobacco use and to assess knowledge, attitude, practices about tobacco use and antitobacco act. Systematic random sampling was done to select study subjects. Total calculated sample size was 880. One eligible male and one female were selected randomly from household. Knowledge was assessed using semi-structured interview schedule while attitude using five-point likert scale. In addition, focus group discussions and in-depth interviews were conducted among various stakeholders and opinion leaders to get insight about practices and factors determining tobacco use in the community. Results: Total 892 subjects were enrolled in the study, of which 51% were male. The mean age of the study subjects was 49.5 years (standard deviation: 17.5). Though awareness about harmful effects of tobacco use was reported, awareness about legislations under an antitobacco act was poor. Early initiation and continued use of all forms of tobacco were reported. Prevalent practice of tobacco use was attributed to pressure from peer groups, social customs and lack of de-addiction services at the community level by study subjects. Conclusion: Tobacco use in this rural community was mainly attributed to social and cultural factors. A multi-pronged public health approach is needed for addressing this complex problem the community.

PRS3 - Graphic Health Warnings on Cigarette Packs in Qatar: Pre-Implementation Awareness and Perception Among the General Public

 Qatar is among the countries that signed and ratified the World Health Organization’s Framework Convention on Tobacco Control (FCTC) in July, 2004.(1)  Article 11 of the FCTC on packaging and labelling of tobacco products stresses the importance of health warnings describing the harmful effects of tobacco use.  Such warnings and messages on packages may be in the form of or include pictorial health warnings (PHW) or text warnings.(2)  PHW on cigarette packs have been shown to increase cessation behavior among smokers. (3)  Studies in countries which have introduced PHW on cigarette packs demonstrate that this measure is beneficial in improving behavior change. (3 – 5)  There are currently text-only warning labels on tobacco products and laws that impose on tobacco companies to display graphic labels on tobacco products in Qatar are yet to be realized. Graphic health warnings on cigarette packs in Qatar: preimplementation awareness and perception among the general public

A comprehensive, health-promotion approach to tobacco control

reported in this month’s SAMJ. The data sustaining the message were drawn from four Global Youth Tobacco Surveys (GYTSs) conducted among nationally representative samples of South African (SA) school learners during 1999, 2002, 2008, and 2011. The setting was public schools across the 9 provinces of SA, and the more than 7 000 learners in grades 8 - 10, aged 12 - 20 years. The percentage of learners who admitted to being current smokers (smoked a cigarette on at least one day in the 30 days preceding the survey) declined from 23% in 1999 to 16.9% in 2011 - a 26.5% reduction. Reductions in smoking prevalence, however, were less pronounced among girls and among ethnic black learners. These remarkable changes occurred during a time when smoking among young people was on the rise globally. At that time, also the SA Government, of which I was privileged to serve as Minister of Health from 1994 to 1999, was introducing a comprehensive set of health promotion measures to curb the harmful effects of tobacco use on health. [2-5] These included interventions at the ecological level such as legislation banning the advertising of tobacco products, classifying nicotine as an addictive drug, restricting smoking in public places, and increasing excise duties on cigarettes. In addition, there were interventions aimed at the individual such as school health education and improving health literacy, and changes in the national school curriculum declaring nicotine a drug of addiction. The GYTSs show that as well as a 26.5% decline in smoking prevalence among these adolescents over a 12-year period, changes in smoking-related attitudes and behaviours also occurred among these learners, reflecting what were profound socio-cultural shifts in attitudes to smoking in SA society at large during those years, resulting in sustained reductions of 54% in per capita cigarette consumption among adults during the same period. [6] Of concern, however, in the two GYTSs from 2008 to 2011, was an observed increase in smoking prevalence in learners, particularly notable in girls, who are known to be a principal target for the tobacco industry, which seeks to recruit adolescents into a lifetime of addiction to nicotine. These findings are important, as hitherto most nationally representative data on the impact of tobacco control measured over a period of more than a decade came from high-income countries (HIC). The tobacco industry, on the other hand, has targeted lowand middle-income countries (LAMICs) such as our own, where 80% of smokers now reside, as its target for market growth in tobacco consumption over the coming years. The GYTSs demonstrate that public health measures in tobacco control, using a health promotion approach, do work, and could be adopted by countries across the developing world in the setting of the Framework Convention on Tobacco Control (FCTC) for example, [7]

Is the EU Harmonization of Excise Taxes on Tobacco Products a Barrier to Health Promotion?

There is worldwide agreement that tobacco use causes health problems and must be fought. At European Union (EU) level there is general agreement that the harmful effects of tobacco use should be tackled through legislative action. The question is, what legislative measures are required to reduce tobacco consumption? Since the first cigarette was introduced to the market in London in 1861, tobacco and tobacco products have become subject to extensive regulation and heavy taxation. The introduction of excise taxes was a milestone in this area. While the main objective of the first excise taxes on tobacco was fiscal, their function has changed over the years, and today they are also a tool of public health and social policies. This situation gives rise to at least three questions. First, what are the most appropriate forms of taxation, especially in the context of the European single market? Second, can health objectives be achieved through tax policy, and should the EU allow price controls in this area? The EU has gone through a more than thirty-year long process of trying to harmonize tobacco excise taxes within the framework of the internal market, in order to establish the most appropriate taxation. The goal of this process was to harmonize the structure of taxation and tax rates. However, due to national traditions and longstanding historical differences in national tax systems, the EU has failed to impose total harmonization in this area but it has taken steps towards the harmonization of both the tax structure and tax rates. This article analyses the options for introducing measures designed to reduce the consumption of tobacco within the framework of Union law, without problems arising in relation to the structure of Directive 95/59/EC on taxes other than turnover taxes which affect the consumption of manufactured tobacco. This analysis is based on the Irish, French and Austrian rules for setting the retail prices of tobacco products. The article will specifically focus on minimum prices versus taxes as possible instruments in the fight to reduce consumption.

The role of tobacco promoting and restraining factors in smoking intentions among Ghanaian youth

BackgroundIn Western countries, the relationship between smoking intentions and smoking behaviour is well established. However, youth smoking intentions and associated factors in developing countries are largely unexplored and the former may occur for a variety of reasons. We investigated youth smoking intentions in Ghana with regard to several tobacco promoting and restraining factors, including environmental, familial, attitudinal and knowledge measures.MethodsA school-based survey of a representative sample of 12-20-year-olds was conducted in 2008 in Ghana (N = 1338, response rate 89.7%).ResultsIn a bivariate model, both among ever and never smokers, allowing smoking on school compound, exposure to tobacco advertisement and parental smoking were associated with future intention to smoke. Compared to those who agreed that smoking is harmful to health, smoking is difficult to quit and that tobacco should not be sold to minors, those who disagreed or were not sure were more likely to have an intention to smoke. In the multivariate analyses, these associations persisted, except that the attitude measures concerning the difficulty of quitting smoking once started and tobacco sales ban were no longer significantly associated with smoking intentions.ConclusionsThese findings underscore the importance of school smoking policy, parental smoking behaviour and knowledge of the harmful effects of tobacco use in determining Ghanaian youths’ future smoking intentions. Because current high percentages of smoking intentions may turn into high smoking rates in the future, the introduction of effective tobacco control measures at all levels of society to prevent youth smoking in Ghana may be essential.

The U.S. Plays Catch Up

According to the Centers for Disease Control and Prevention, tobacco kills more than 5 million people per year worldwide — more than HIV, tuberculosis, and malaria combined. The CDC estimates that more than 1 billion people will die this century from tobacco-related illness unless urgent action is taken. The World Health Organization is well aware of these statistics. To date, 172 countries have adopted the WHO’s Framework Convention on Tobacco Control (FCTC), the world’s first public health treaty. The framework, which uses a global approach to combating the tobacco epidemic, requires tobacco products to carry warning labels covering at least 30% – 50% of the package’s principal display areas — preferably with graphic pictures or illustrations — portraying the harmful effects of tobacco use. Although the U.S. has not officially signed on to WHO FCTC, the new U.S. warning labels match the labeling initiatives efforts adopted by countries that have. To assess how the health warnings will affect individual interest in quitting smoking, CDC researchers reviewed data from the 2008 – 2010 Global Adult Tobacco Survey culled from 14 FCTC countries. Their findings appeared in the May 26, 2011, issue of the CDC’s Morbidity and Mortality Weekly Report. Their study found that most men and women smokers surveyed said they noticed the warnings on the cigarette packages and more than 25% in all countries (excluding Poland) were thinking about quitting because of the warnings. In Bangladesh, Brazil, India, Thailand, Ukraine, and Vietnam, 50% said they were considering quitting. For further evidence that the labels can work, the U.S. only needs to look north. Although the U.S. was first with warning labels in 1966, approximately 10 years ago, Canada became the first country to carry graphic warning labels. Between 1999 and 2009, the number of Canadian smokers aged 15 – 19 years has dropped from 28% to 13%, and adult smoking has decreased from 25% to 17.5%. According to Hammond, “While not all of that is due to the labels, about 30% – 40% of Canadian smokers have said the warning helped them to make a quit attempt, and of those who did quit, about 30% say the warnings helped them to ‘stay quit. ’ ”

Perceptions and Practices of Japanese Nurses Regarding Tobacco Intervention for Cancer Patients

BackgroundWe investigated the perceptions and practices regarding tobacco intervention among nurses, as improvement of such practices is important for the management of patients who smoke.MethodsSelf-administered questionnaires were delivered by hospital administrative sections for nursing staff to 2676 nurses who were working in 3 cancer hospitals and 3 general hospitals. Of these, 2215 (82.8%) responded.ResultsMost nurses strongly agreed that cancer patients who had preoperative or early-clinical-stage cancer but continued to smoke should be offered a tobacco use intervention. In contrast, they felt less need to provide tobacco use intervention to patients with incurable cancer who smoked. Most nurses felt that although they assessed and documented the tobacco status of cancer patients, they were not successful in providing cessation advice, assessing patient readiness to quit, and providing individualized information on the harmful effects of tobacco use. In multivariate analysis, nurses who received instruction on smoking cessation programs during nursing school were more likely to give cessation advice (odds ratio, 1.61; 95% confidence interval, 1.15–2.26), assess readiness to quit (1.73, 1.09–2.75), and offer individualized explanations of the harmful effects of tobacco (1.94, 1.39–2.69), as compared with nurses who had not received such instruction.ConclusionsThe perceptions of Japanese nurses regarding tobacco intervention for cancer patients differed greatly by patient treatment status and prognosis. The findings highlight the importance of offering appropriate instruction on smoking cessation to students in nursing schools in Japan.