title: What are the factors that influence the delivery of smoking cessation advice in critical care?
abstract: BACKGROUND
  The world's leading cause of preventable deaths, diseases and disabilities is smoking. Hospitalization can provide an opportunity for smokers to quit. Previous research found that smokers make up a high percentage of patients admitted to intensive care. Health care professionals working in critical care environments can make a valuable contribution to this public health issue by providing smoking cessation advice.
  
  
  OBJECTIVE
  To identify factors that inhibit and facilitate the delivery of smoking cessation advice by nurses and doctors in critical care settings.
  
  
  METHODS
  Quantitative design using an online survey.
  
  
  METHODS
  This research was a single centre study carried out in a large tertiary hospital. Study sites were two adult critical care departments including a 14-bed general intensive care and a 16-bed cardiovascular intensive care unit. The target population for this research was the nursing and medical staff working in adult critical care environments.
  
  
  RESULTS
  The data suggests that doctors and nurses have a good understanding of the complications related to tobacco use and also have education on smoking cessation. Additionally the data suggest that doctors and nurses at the study sites generally have positive attitudes towards smoking cessation. Patient acuity and competence were concerns raised in relation to the delivery and effectiveness of smoking cessation advice in critical care environments.
  
  
  CONCLUSIONS
  The recovery phase following critical illness might be an opportunity to provide cessation advice. This could include focusing cessation advice efforts on awake, orientated and extubated patients. Further research might be required to confirm this.
  
  
  CONCLUSIONS
  The provision of smoking cessation advice is an on-going World Health Organization and New Zealand Government priority and all parts of the health sector need to provide responses. However, responses need to be adapted to the specific context such as the unique challenges of critical care.
authors.affiliation: Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Markus
authors.initials: M
authors.lastname: Lang
authors.affiliation: Faculty of Medical and Health Sciences/School of Nursing, University of Auckland, Auckland, New Zealand.
authors.forename: Susan
authors.initials: S
authors.lastname: Waterworth
authors.affiliation: Faculty of Medical and Health Sciences/School of Nursing, University of Auckland, Auckland, New Zealand.
authors.forename: Anthony
authors.initials: A
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003422:Critical Care; D005260:Female; D006801:Humans; D020407:Internet; D008875:Middle Aged; D009520:New Zealand; D024802:Nurse's Role; D010353:Patient Education as Topic; D010819:Physician's Role; D012907:Smoking; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Critical care; Nurses and doctors; Patient acuity; Patient competence; Smoking cessation