Content area
Full Text
Treatment of tobacco dependence is one of the most effective ways to prevent disease and promote health among individuals of all ages. Although smoking cessation can be difficult to accomplish, support and assistance from skilled health care providers can make a critical difference in success rates. According to the American Cancer Society (2003), only 5% of individuals attempting to quit on their own are successful. With assistance, this rate can be increased to more than 16% (Osinubi et al., 2003). This column is the second of a three-part series and focuses on smoking cessation counseling and behavioral therapies. The first article, which appeared in the February issue (Vol. 53, No. 2, pp. 63-64), reviewed the epidemiology of smoking, the adverse effects of smoking, and an approach to identify individuals ready to quit. Part III will focus on the pharmacotherapy of smoking cessation and summarize the role of the clinician in smoking cessation efforts.
The Healthy People 2010 national goals include an objective addressing smoking cessation. It is recommended that 85% of health care providers routinely identify smoking status in clients and provide smoking cessation counseling and follow up according to current clinical practice guidelines (U.S. Department of Health and Human Services & Office of Disease Prevention and Health Promotion, 2000). Currently, only approximately 50% of smokers report receiving offers of assistance to quit and subsequent follow-up (Pbert, 2003). However, those clients who receive assistance from an advanced clinician have twice the abstinence rate at 5 or more months than those without this assistance (Fiore et al., 2000). Clients who attend one counseling session have a 12.4% quit rate, as compared to a 24.7% quit rate for those attending more than eight sessions.
In spite of the severe consequences in terms of morbidity and mortality and the identification of tobacco-related risk factors for multiple diseases, smoking cessation education is not included in most medical and nursing curricula. Already over-full curricula and increasing demands on building knowledge sets in other health areas have overshadowed this need. In addition, the ability and motivation to counsel and assist in smoking cessation activities is not intuitive. Building tobacco education competency in health care providers requires provision of specific knowledge and skills and the promotion of compliance with established clinical guidelines...