I agree that hospitals should be labeled "no tobacco zones," that nurses should play a leading role in helping patients to stop tobacco use, and that such knowledge and skills should be included in basic nursing curriculum ("Health Care Providers Who Smoke," Viewpoint, June).
Nurses make up the largest number of health care providers with direct patient contact. We provide much of the education patients receive and are crucial to their ability to understand and implement a treatment plan. Patients trust us. If we don't address tobacco use, our patients will assume it's not important to their health status. Nurses and other health care providers indicate that they're not confident in their ability to counsel patients about smoking cessation because of limited education in the clinical curriculum. Because effective, evidence-based treatments are available to help people quit, it's unthinkable that the nursing curriculum would fail to address this.
The rate of adult tobacco use in New York State (17%) is lower than the national average (21%). The New York State Department of Health reports that clinicians in group practices assess for tobacco use status 88% of the time and provide assistance with quitting 51% of the time.1 Not perfect, but better than the statistics reported by the Viewpoint's author, Ayad Jindeel, MD.
Tobacco Cessation Centers are a unique component of the New York State Tobacco Control Program. They're designed to assist health care providers in implementing the Public Health Service's guidelines (http://www.ahrq.gov/path/tobacco.htm#Clinic). This involves clinical education, systems and policy changes, technical assistance, and provider support. The Tobacco Cessation Centers' Education Task Force has worked with colleges of nursing throughout the state to introduce needed curriculum changes that will result in the outcomes Dr. Jindeel supports. It's making a difference.
Leslie K. Holmberg, MS, RN, CAS-Ed
Director, The Tobacco Cessation Center at St. Josephs Hospital, Syracuse, NY