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To the Editors:

The article "Tobacco Dependence Curricula in Acute Care Nurse Practitioner Education" by Heath et al (January 2002:27–33) raised a great deal of personal concern regarding the inadequate content and extent of tobacco education curricula in acute care nurse practitioner (ACNP) programs. Of utmost concern to me is that these educational programs are not consistently using nationally accepted guidelines to provide a basis for their curricula. As reported in the article, only 40% of ACNP programs surveyed reported using the Agency for Healthcare Research and Quality guidelines for smoking cessation as a curriculum reference. As I struggle to find my role as an intensive care nurse and family nurse practitioner student in helping patients to quit smoking, I can appreciate the introduction of a uniform guideline upon which to base my practice.

Hopefully, the publication of the most recent guideline, Treating Tobacco Use and Dependence: A Clinical Practice Guideline,¹ will create a more consistent approach to teaching and implementing tobacco interventions. This guideline implies a culture of healthcare in which failure to treat tobacco use—the chief cause of preventable death—constitutes an inappropriate standard of care.

It becomes the responsibility of healthcare educational institutions to introduce this guideline to students in order for them to have a foundation of basic knowledge upon which they can base their practice. Medical schools, dental schools, nursing schools, and other health educational programs need to incorporate this guideline into their educational programs. Heath et al came to the conclusion that all levels and specialties of nursing education probably do not include adequate coverage of tobacco dependence.

As smoking continues to cause strokes, heart attacks, cancer, other acute and chronic illnesses, and death, I feel certain that not enough is being done to achieve smoking cessation and prevent individuals from starting to smoke. If more time and effort were spent on tobacco dependence curricula in nursing programs, specifically introducing Treating Tobacco Use and Dependence: A Clinical Practice Guideline,¹ nurses of all levels would have the knowledge necessary to intervene to decrease the prevalence of smoking and morbidity and mortality related to smoking.

Erin Wheeler, RN, BSN
Centralia, Mo

Reference

1. U.S. Department of Health and Human Services. Treating tobacco use and dependence: a clinical practice guideline. Available at: http: //www.surgeongeneral.gov/tobacco/default.htm. Accessed on May 10, 2002.

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