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Nursing practice and work environment

According to the Centers for Disease Control and Prevention (CDC), 18% of Americans smoke cigarettes and more than half of these smokers want to quit. Further, CDC reports that tobacco use is responsible for more than 480,000 deaths in the United States annually. The negative health effects of cigarette smoking are well recognized—multiple cancers, diabetes, chronic obstructive pulmonary disease, rheumatoid arthritis, cardiovascular disease, and others.

Secondhand cigarette smoke (smoke exhaled from a smoker or emitted from the burning end of a cigarette) is estimated to cause 42,000 deaths of nonsmokers annually, according to the American Cancer Society. It is known to cause cardiovascular disease, lung cancer, and sudden infant death syndrome and to aggravate or trigger childhood asthma attacks.

Thirdhand smoke refers to lingering tobacco residue from tobacco smoke. It is found in curtains, carpets, walls, furniture, and other items where smokers have been. Current research links negative health effects to involuntary tobacco exposure.

Tobacco use comes in many forms—not only in cigarettes, chewing tobacco, and cigars but in nontraditional tobacco products, such as electronic cigarettes (“vapes”), hookahs (water pipes), and dissolvable nicotine (tablets or strips). The marketing, manufacture, and distribution of some traditional tobacco products are subject to regulation by the United States Food and Drug Administration (FDA). Unfortunately, the environmental impacts and individual and population health effects of nontraditional tobacco products are not subject to the same level of scrutiny. Research is needed to better understand the health risks related to these products to ensure that the public is protected.

What can nurses do?

RNs can assist patients in tobacco cessation. The U.S Agency for Healthcare Research and Quality recommends the “Five A’s”:

  • Ask about tobacco use at every visit.
  • Advise the tobacco user to quit in a personalized manner.
  • Assess the tobacco user’s willingness to quit.
  • Assist willing patients to quit through counseling, pharma­cotherapy, or other evidence-based modalities.
  • Arrange follow-up contact within the first week of the quit date.
    Additionally:
  • Engage in and advocate for research on the health and safety effects of nontraditional tobacco products.
  • Petition the FDA to regulate all tobacco products.
  • If you use tobacco, set a quit plan in motion.
  • Get involved with professional association work on tobacco cessation, such as ANA’s statement above

For more information, visit these websites:

Holly Carpenter is a senior staff specialist in Nursing Practice and Work Environment at ANA.

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