Nursing interventions for smoking cessation.
BACKGROUND
Health care professionals, including nurses, frequently advise patients to improve their health by stopping smoking. Such advice may be brief, or part of more intensive interventions.


OBJECTIVE
To determine the effectiveness of nursing delivered smoking cessation interventions.


METHODS
The Cochrane Tobacco Addiction Group register was searched for studies of interventions using nurses or health visitors and an additional search made on CINAHL.


METHODS
Randomised trials with follow-up of at least 6 months.


METHODS
Two authors extracted data independently.


RESULTS
Sixteen studies comparing nursing intervention to a control or usual care found intervention to significantly increase the odds of quitting (Peto Odds Ratio 1.50, 95% CI 1.29-1.73). There was heterogeneity between the study results, but pooling using a random effects model did not alter the estimate of effect. There was no evidence from indirect comparison that interventions classified as intensive had a larger effect than less intensive ones. There was limited evidence that interventions were more effective for hospital inpatients with cardiovascular disease than for inpatients with other conditions. Interventions in non hospitalised patients also showed evidence of benefit. Five studies of nurse counseling on smoking cessation during a screening health check, not included in the main meta-analysis, found that under these conditions nursing intervention had less effect.


CONCLUSIONS
The results indicate the potential benefits of smoking cessation advice and counseling given by nurses to their patients, with reasonable evidence that interventions can be effective. The challenge will be to incorporate smoking cessation intervention as part of standard practice so that all patients are given an opportunity to be queried about their tobacco use and to be given advice to quit along with reinforcement and follow-up.
Rice
V H
VH
College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, Michigan 48202, USA. Vfrice@aol.com
Stead
L F
LF
D003376:Counseling; D006801:Humans; D009723:Nurse-Patient Relations; D009732:Nursing Care; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention