title: Tobacco prevention and reduction with nursing students: A non-randomized controlled feasibility study.
abstract: BACKGROUND
  Prevalence of tobacco use among nurses and nursing students is disproportionally high in Germany. However, from a public health perspective they are considered to be an important group for delivering smoking cessation interventions. As delivery of tobacco-related treatment depends on own smoking status, smoking prevention and cessation among the nursing professions is indicative for improving nurse and public health.
  
  
  OBJECTIVE
  To evaluate the feasibility and effects of a comprehensive tobacco prevention and reduction program on psychosocial and environmental factors related to smoking behavior of nursing students.
  
  
  METHODS
  Between 2014 and 2015, a non-randomized, controlled feasibility study was conducted in 12 schools of nursing with 397 nursing students in Germany. Students in the intervention group received a program (ASTRA) consisting of an introductory session, steering committee workshop, stress prevention lessons, evidence-based smoking cessation intervention, and action project. Six months after baseline assessment, change in smoking-related protective and risk factors was determined. Secondary endpoints included smoking behavior.
  
  
  RESULTS
  The program was implemented in total in 5 of 7 intervention schools. About one third of smoking nursing students participated in a cessation intervention. The program seems to do better than a minimal intervention booklet in four primary outcomes: perceived descriptive, subjective, and injunctive norms towards smoking and nursing as well as perceived social support. As anticipated, there was no change in smoking behavior.
  
  
  CONCLUSIONS
  The applied approach is feasible and able to improve important smoking-related norm perceptions of student nurses and perception of social support. However, additional context measures to influence the settings of nursing education currently rather supporting smoking seem to be necessary in order to promote smoking cessation among nursing students and to scale up implementation of the program.
authors.affiliation: IFT Institut für Therapieforschung, München, Parzivalstr. 25, D-80804, München, Germany. Electronic address: buehler@ift.de.
authors.forename: Anneke
authors.initials: A
authors.lastname: Bühler
authors.affiliation: IFT Institut für Therapieforschung, München, Parzivalstr. 25, D-80804, München, Germany. Electronic address: schulze@ift.de.
authors.forename: Katrin
authors.initials: K
authors.lastname: Schulze
authors.affiliation: Deutsches Netzwerk rauchfreie Krankenhäuser (DNrfK), Pettenkoferstrasse 16-18, D-10247, Berlin, Germany. Electronic address: christa.rustler@rauchfrei-plus.de.
authors.forename: Christa
authors.initials: C
authors.lastname: Rustler
authors.affiliation: Deutsches Netzwerk rauchfreie Krankenhäuser (DNrfK), Pettenkoferstrasse 16-18, D-10247, Berlin, Germany. Electronic address: sabine.scheifhacken@rauchfrei-plus.de.
authors.forename: Sabine
authors.initials: S
authors.lastname: Scheifhacken
authors.affiliation: Hochschule Esslingen, Flandernstr. 101, D-73732 Esslingen a.N., Germany. Electronic address: Ines.Schweizer@hs-esslingen.de.
authors.forename: Ines
authors.initials: I
authors.lastname: Schweizer
authors.affiliation: Hochschule Hannover, Blumhardtstraße 2, D-30625, Hannover, Germany. Electronic address: mathias.bonse-rohmann@hs-hannover.de.
authors.forename: Mathias
authors.initials: M
authors.lastname: Bonse-Rohmann
mesh_terms: D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006293:Health Promotion; D006801:Humans; D008297:Male; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013338:Students, Nursing / Q000523:psychology*; D055815:Young Adult; D014026:Nicotiana
keywords: Cessation; Feasibility studies; Nursing students; Prevention; Smoking; Tobacco use