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American Journal of Critical Care. 2002;11: 317
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LETTERS TO THE EDITORS

To the Editors:

I was surprised when I read the article "Tobacco Dependence Curricula in Acute Care Nurse Practitioner Education" by Heath et al (January 2002:27–33) and discovered that acute care nurse practitioner programs were spending so little time (1–3 hours overall for 70% studied) on smoking-cessation education.1 Having just started a nurse practitioner program myself, I am concerned about the amount of education that I will receive on this subject.

While reading the article, I realized that I had never heard of the 5 R’s or 5 A’s of smoking cessation. According to Heath et al, 24% of the programs surveyed did not cover this topic at all. With a little searching, I discovered that these techniques are included in the national guidelines provided by a panel representing the Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, and several other national health organizations.1,2

What concerns me most is that nursing schools aren’t teaching more of these practical applications to practice, especially to advanced practice nurses. Why is that? This question is especially pertinent when access is available to these guidelines via the Internet. Research has shown that nurses are effective in helping patients quit smoking.3 Why not take advantage of this opportunity by educating those who are in the best position to make a difference with the latest techniques? If advanced practice nurses are to be leaders in the profession, I believe it should be a high priority of advanced practice nursing education to include national guidelines on smoking cessation in the basic curricula taught to future clinicians.

Jill Parker, RN, BSN
Greensboro, NC

References

  1. Department of Health and Human Services. Treating tobacco use and dependence. Quick reference guide for clinicians. Available at: http://www-.surgeongeneral.gov/tobacco/tobaqrg.htm. Accessed on October 2000.
  2. Goolsby MJ. Treating tobacco use and dependence. J Am Acad Nurse Practit. 2001;13:101–105.
  3. Rice VH, Stead LF. Nursing interventions for smoking cessation. Available at: www.cochrane.hcn.net.au/CLIB/. Accessed on January 30, 2002.
The authors reply

It is energizing to hear the interest that our study sparked in critical care nurses concerning the lack of education that acute care nurse practitioners are receiving about tobacco prevention and smoking cessation in their program of studies. As the largest healthcare profession, nurses are in a prime position to help reduce the deadly effects related to tobacco dependence, but they need the skills set to do this effectively. A grant to implement a Summer Institute for Tobacco Control Practices in Nursing Education at Georgetown University is currently under review. If funded, nursing educators will have an opportunity to attend a 2-day comprehensive course to receive "all the tools" necessary for teaching the Agency for Healthcare Research and Quality national guidelines for smoking cessation. It will take a sustained advocacy and grassroots effort for tobacco control practices to be a higher priority in nursing curricula. We encourage others to "raise their voices" in support of learning interventions to reduce the morbidity and mortality from tobacco-related diseases.

Janie Heath, RN, MS, CCRN, ANP, ACNP, Jeannette Andrews, RN, CS, MSN, FNP, ACNP, Sue Ann Thomas, RN, PhD, Frances J. Kelley, RN, PhD, FNP and Erika Friedman, PhD




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