434 Nursing interventions effective for smoking cessation

July 11, 2014

PEARLS 434, June 2014, written by Brian R McAvoy

Clinical question
How effective are nursing-delivered smoking cessation interventions?

Bottom line
There was moderate-quality evidence that advice and support from nurses could increase people's success in quitting smoking (for at least 6 months), especially in a hospital setting. Similar advice and encouragement given by nurses at health checks or prevention activities seemed to be less effective, but still had some impact. Providing additional physiological feedback, in the form of spirometry and demonstrated carbon monoxide level, as an adjunct to nursing intervention did not appear to have an effect. Nicotine replacement therapy has been shown to improve quit rates when used in conjunction with counselling for behavioural change and should be considered an important adjunct, but not a replacement for nursing interventions.¹

Caveat
Results were not consistent across all studies and, in some cases, there were not very many studies contributing to comparisons. A difference among the studies that may have contributed to the differences in outcome was baseline cigarette use. There was an inverse relationship between number of cigarettes smoked per day and success in quitting.

Context
Most smokers want to quit and may be helped by advice and support from healthcare professionals. Nurses are the largest healthcare workforce and are involved in virtually all levels of healthcare.

Cochrane Systematic Review
Rice VH et al. Nursing interventions for smoking cessation. Cochrane Reviews, 2013, Issue 8. Art. No.: CD001188.DOI: 10.1002/14651858. CD001188.pub4. This review contains 49 studies involving over 17,000 participants.

1. Stead LF et al. Cochrane Database Syst Rev 2012; Issue 11. DOI: 10.1002/14651858.CD000146.pub4

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.