The Role Nurses can Play in Helping Patients Quit Smoking

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Young woman smoking

Cigarette smoking is the leading cause of preventable disease and death in the U.S., says the U.S. Centers for Disease Control and Prevention. Smoking accounts for more than 480,000 deaths per year in this country or 1 in every 5 fatalities. “The act of smoking isn’t just a bad habit, it’s a physiologic and psychological addiction,” says Sally Jo Borello, MSN, RN, CTTS in the article Help your patients with smoking cessation.

There is no way to portray smoking as something less than serious in this country. With more than 16 million Americans living with a smoking-related disease (as of 2015) the involvement of medical professionals to help patients quit can make a huge difference. And, nurses are in a prime position to motivate patients to consider quitting because they’re often the first point of contact a patient has in a clinical setting.

Talk to and educate your patients

Smokers expect to hear concern about their smoking when in a health setting, so take advantage of this presumption to address the issue seriously and from an educational standpoint. Even though most smokers know they’re more susceptible to lung cancer, emphysema and heart disease, sometimes this knowledge isn’t enough to begin the process of quitting, which is why you can use every clinical opportunity to address the need for a patient to quit smoking. Simple inquiries like, “Do you smoke?” or “Do you want to quit?” get the conversation started and can potentially be enough to motivate smokers to consider taking positive steps toward quitting. Some strategies to employ during the conversation include:

Being aggressive about the risks – Don’t hesitate to share real and impactful information with patients in order to get their attention. Information like this, from the National Institutes of Health, can be impactful:

  • Cigarette smoking now causes 1,000 Americans to die on a daily basis
  • Smoking-related deaths are the single, most important preventable death in the U.S.

Additionally, you can broaden the list of diseases and illnesses a smoker is at increased risk for beyond, focusing on the other types cancer — mouth and larynx, stroke, chronic pulmonary disease and coronary heart disease. If your patient has a pre-existing condition like diabetes or high blood pressure stress the increased health risks they’re susceptible to as a smoker, especially in reference to heart disease. If you’re working with female patients, make sure they understand the risks involved with being a smoker and taking birth control if applicable. Women on birth control who smoke increase their risk of heart attack and stroke by 10 percent according to the National Institutes of Health.

Highlighting the benefits of quitting – Continue to tell patients more than they already know by talking about the everyday benefits to quitting smoking. These might not connect to the decrease in health risks quitting leads to, but may strike a chord with smokers since they’re more immediately relatable. Remind smokers that quitting means your home, car, clothes and hair stop smelling like smoke. Non-smokers experience less coughs and colds and typically have more stamina during vigorous activity. Bring loved ones into the conversation too by reminding smokers that when they quit, the people they’re around most have fewer health risks from inhaling second-hand smoke.

It may also make an impact to mention how immediate the health benefits are when a smoker quits. While patients may be aware that their lungs will quickly begin cleaning and repairing themselves, they might not know that quitting smoking returns your heartbeat to normal and increases the oxygen level in your blood back to normal. Smokers may not even be aware these two things are abnormal when they smoke and bringing it to their attention could make a difference in their motivation to quit.

Quitting doesn’t end the conversation – To remain smoke-free, patients should avoid tempting situations and strategize on ways to occupy themselves when the urge to smoke returns. As a nurse, learning about what triggers a patient to want to smoke can help you continue supporting them. Discuss how to avoid temptation and offer them suggestions on what they can do instead of smoking such as drinking water, moving around or keeping their hands busy with something else. Emphasize that the urge to smoke does eventually fade, but they need to actively participate in distracting themselves from cigarettes.

Be involved and get support from colleagues

It’s important to be attentive to the response patients give when the topic of smoking is broached. Are they simply unable to quit on their own? Are they asking for help? If more than a conversation is necessary to support a patient’s desire to quit, provide them with options for additional support. This may include sharing information on nicotine replacement therapy, a smoking cessation program or working with other health professionals. You may also want to consider tracking the patient’s smoking history and their path to quitting in order to appropriately personalize the conversation at future visits.

When you know a patient smokes but is struggling with quitting, get the doctor involved in the conversation. Encourage other nurses and health care providers to have a dialogue with the patient. “Repetition of the same no-smoking message by several sources will encourage smokers to think more seriously about quitting smoking,” notes the National Institutes of Health.

Have realistic expectations

Nearly half of all adults who ever smoked have quit for life, but it may take a few attempts before they can finally call themselves a non-smoker. Even if you can’t help a patient completely quit smoking the first time around, you can help them move further along through the four stages of quitting, which are:

  • Precontemplation – thinking about quitting, but not yet serious enough to take action
  • Contemplation – weighing the pros and cons to get ready to move forward
  • Action – deciding it’s time to quit and taking action to stop
  • Maintenance – successfully continuing to be a non-smoker

Even just a little push can get a patient a little bit closer to becoming a non-smoker. Typically, the most encouragement and support is needed while patients are in the first two stages of the process. Keep in mind though that reaching the maintenance stage doesn’t mean they will be a non-smoker for life. Having the realistic expectation that a relapse can happen is important in order to continue the smoking conversation with patients and stay on top of their health.

Preparing yourself to help smokers quit

90 percent of former smokers quit on their own without participation in a formal program, according to the National Institutes of Health. That means you can make a difference just by steering a conversation toward quitting. Make sure you’re prepared to have this conversation and others entered directly on a patient’s health with the right combination of experience and education. The online RN to Bachelor of Science in Nursing from Rutgers University focuses on the foundations of nursing leadership alongside the nuances of delivering comprehensive care. An RN-BS from Rutgers University, a leader in higher education, can elevate your education to meet the industry’s complex demands in patient care and nurse responsibility.

Recommended Readings:
Management 101: Leadership Advice for Nurses
How Nursing Creates Health Communities
Trends in Patient Care that will Affect Nurses in 2017


Bachelor of Science in Nursing