BACKGROUND: Persons with mental illness smoke proportionately more cigarettes and die earlier than the general population. Yet compared with other clinicians, psychiatric professionals have intervened slowly with smoking patients. To assess psychiatric nurses' perspectives concerning tobacco dependence interventions, the American Psychiatric Nurses Association (APNA) Tobacco Dependence Task Force surveyed email-accessible APNA members (N = 1,365).OBJECTIVES: This paper reports survey results and implications for psychiatric nursing.STUDY DESIGN:Cross-sectional analysis of a 29-item online survey conducted in early 2008.RESULTS:Most nurses asked if patients smoked but fewer advised against smoking, referred to cessation resources, or delivered intensive interventions. Nurses referred to resources if they felt motivated, knowledgeable, and/or confident in their skills and rated highly their patients' ability and/or motivation to quit smoking. Workplace characteristics were related to nurses' behaviors. Nursing curricula lack tobacco dependence content.CONCLUSIONS: Findings will guide efforts to support nurses in reducing/eliminating smoking by their patients through practice, education, research, and policy initiatives.
American Psychiatric Nurses Association, International Society of Psychiatric-Mental Health Nurses, & American Nurses Association. (2007). Psychiatric-mental health nursing: Scope and standards of practice. Silver Spring, MD: American Nurses Association.
2.
Braun, B.L., Fowles, J.B., Solbert, L.I., Kind, E.A., Lando, H., & Pine, D. (2004). Smoking-related attitudes and clinical practices of medical personnel in Minnesota. American Journal of Preventive Medicine, 27, 316-322.
3.
Christakis, N.A., & Fowler, J.H. (2008). The collective dynamics of smoking in a large social network. New England Journal of Medicine, 358, 2249-2258.
4.
el-Guebaly, N., Cathcart, J., Currie, S., Brown, D., & Gloster, S. (2002). Smoking cessation approaches for persons with mental illness or addictive disorders. Psychiatric Services , 53, 1166-1170.
5.
Evins, A.E., Cather, C., Deckersbach, T., Freudenreich, O., Culhane, M.A., Olm-Shipman, C.M., et al. (2005). A double-blind placebo-controlled trial of bupropion sustained-release for smoking cessation in schizophrenia. Journal of Clinical Psychopharmacology, 25, 218-225.
6.
Fiore, M.C., Bailey, W.C., Cohen, S.J., Dorfman, S.F., Goldstein, M.G., Gritz, E.R., et al. (2000). Treating tobacco use and dependence: A clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services.
7.
Fiore, M.C., Jaén, C.R., Baker, T.B., Bailey, W.C., Benowitz, N.L., Curry, S.J., et al. (2008). Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services.
8.
George, T.P., Syeal, A.A., Dolan, S.L., Dudas, M.M., Termine, A., & Vessicchio, J.C. (2002). Nicotine addiction and schizophrenia: A clinical approach. Primary Psychiatry, 9(11), 48-53.
9.
Hogan, M.F. (2003). The President's New Freedom Commission: Recommendations to transform mental health care in America. Psychiatric Services , 54, 1467-1474.
10.
Morris, C., Waxmonsky, J., Giese, A., Graves, M., & Turnbull, J. (2009, January). Smoking cessation for persons with mental illnesses: A toolkit for mental health providers. Denver, CO: State Tobacco Education and Prevention Partnership . Retrieved March 9, 2009, from http://smokingcessationleadership.ucsf.edu/Downloads/catalogue/MHtoolkitJan_2009.pdf
11.
National Association of State Mental Health Program Directors. (2007). Tobacco-free living in psychiatric settings: A best-practices toolkit promoting wellness and recovery. Alexandria, VA: Author. Retrieved October 24, 2007, from http://www.nasmhpd.org/general_files/publications/NASMHPD.toolkitfinalupdated90707.pdf
12.
Parks, J., Radke, A. Q., & Mazade, N. A. (Eds.). (2008). Measurement of health status for people with serious mental illness. Alexandria, VA: National Association of State Mental Health Program Directors Medical Directors Council.
13.
Saad, L. (2008, November 24). Nurses shine, bankers slump in ethics ratings: Annual Honesty and Ethics poll rates nurses best of 21 professions . Retrieved February 11, 2009, from http://www.gallup.com/poll/112264/Nurses-Shine-While-Bankers-Slump-Ethics-Ratings.aspx
14.
Sarna, L., Bialous, S.A., Jun, H.-J., Wewers, M.E., Cooley, M.E., & Feskanich, D. (2008). Smoking trends in the Nurses' Health Study (1976-2003) . Nursing Research, 57, 374-382.
15.
Sarna, L., Wewers, M.E., Brown, J.K., Lillington, L., & Brecht, M.-L. (2001). Barriers to tobacco cessation in clinical practice . Nursing Outlook, 49, 166-172.
16.
Schroeder, S.A. (2008). Stranded in the periphery:The increasing marginalization of smokers. New England Journal of Medicine, 358, 2249-2258.
17.
Slater, P., McElwee, G., Fleming, P., & McKenna, H. (2006). Nurses' smoking behaviour related to cessation practice. Nursing Times, 102(19), 32-37.
18.
Steinberg, M.B., Foulds, J., Richardson, D.L., Burke, M.V., & Shah, P. (2006). Pharmacotherapy and smoking cessation at a tobacco dependence clinic. Preventive Medicine, 26, 114-119.
19.
Strasser, K.M. (2001). Smoking reduction and cessation for people with schizophrenia: Guidelines for general practitioners. South Melbourne, Victoria: SANE Australia. Retrieved June 19, 2008 , from http://www.health.vic.gov.au/mentalhealth/publications/smoke/smoke/pdf
20.
Trinkoff, A.M., & Storr, C.L. (1998). Substance use among nurses: Differences between specialties. American Journal of Public Health, 88, 581-585.
21.
Williams, J.M., & Ziedonis, D. (2006). Snuffing out tobacco dependence: Ten reasons behavioral health providers need to be involved. Behavioral Healthcare , 26, 27-31.
22.
Ziedonis, D., Hitsman, B., Beckham, J.C., Zvolensky, M., Adler, L.E., Audrain-McGovern, J., et al. (2008). Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report. Nicotine & Tobacco Research, 10, 1691-1715.
23.
Ziedonis, D.M., Williams, J.M., & Smelson, D. (2003). Serious mental illness and tobacco addiction: A model program to address this common but neglected issue. American Journal of the Medical Sciences, 326, 223-230.
24.
Ziedonis, D.M., Williams, J.M., Steinberg, M.B., & Foulds, J. (2006). Addressing tobacco addiction in office-based management of psychiatric disorders: Practical considerations. Primary Psychiatry, 13, 51-73.
