Tobacco Smoking and Primary Care

Introduction

Tobacco smoking is considered one of the preventable causes of deaths in the UK and globally. Howevre, according to Wallace-Bell (2003), practitioners can play a pivotal role in working with the patient to deliver primary care and assist in the secession of the habit. This essay uses the DIEP (describe, interpret, evaluate and plan) strategy to reflect on my experience as primary care nurse in delivering care to ‘John,’ a 25-year-old student in my who had been smoking since for five years. John was admitted in the hospital for chest pain and based on my professional responsibility and duty of care; I took that opportunity to help him to manage his smoking habit.

The most interesting thing I learned from my interaction with John is that practitioners are in a better position to encourage smokers to quit especially in ‘No Smoking’ environments such as the hospital setting. A possible implication of this new idea is that when smoking patients feel a sense of vulnerability, they are more willing to accept assistance to quit. Similar remarks are made by McKenna et al (2001) who observed that hospital admission is the best opportunity for practitioners to help smokers quit because practitioners are able to professionally interact with them and provide them with appropriate information that may help them quit. This realization is valuable; for it will change the way I approach tobacco smokers by advising them to seek hospital admission because they are more likely to get better assistance to quit. This new insight will also be useful in my personal life as I assist some of my family members to quit smoking.

Another significant issue I realize now is that practitioners can implement brief interventions to manage and assist smokers quit; especially at admission of the patient, during patient assessment and during general nursing care. For instance, when I was handling John, I took that opportunity to advise, encourage, discuss and negotiate with him about smoking and how he can quit.

This realization may have important relevance for several reasons. First, brief interventions for tobacco smokers can take as little as 10 minutes. Secondly, it involves identifying the smoker, establishing their degree of addiction and how ready they are to quit smoking, urging them to quit smoking, agreeing with them on steps to quit smoking (e.g. therapy or behavioural counselling) and finally establishing a follow up strategy such as visits to ensure that they adhere to the cessation strategy. Similar remarks are made by Doherty (2001) who writes that when implementing brief interventions, practitioners need to identify and record the patient’s level of addiction then apply the Prochaska and DiClemente’s Stages of Change Model to assist the patient quit smoking. O’Donovan (2004) also asserts that brief interventions for tobacco smokers are stepwise and are meant to help smokers quit; by moving from one step to another – towards a tobacco-free life.

Indeed, understanding the concept of brief intervention will change the way I approach smoking patients because it will only take me approximately 10 minutes to administer an intervention that would assist them to quit. This new insight is also useful to my personal life because it will assist me to deliver care to members of my family who are smokers.

References

Doherty C. (2001) Nurse-Delivered Smoking Cessation Interventions For Patients Attending The Cardiovascular Services In St James’s Hospital, Dublin. J Health Gain; 8-9.

Mckenna Et Al. (2001) Qualified Nurses’ Smoking Prevalence: Their Reasons For Smoking And Desire To Quit, J Advanced Nursing; 35(5): 769-775.

O’Donovan G. (2004) Smoking Prevalence Amongst Qualified Nurses And Their Role In Smoking Cessation. Unpublished Thesis.

Wallace-Bell M. (2003) Smoking Cessation: The Case For Hospital-Based Interventions Professional Nurse; 19(3): 145-148