I would like to applaud your efforts in raising awareness about the terrible impact of tobacco dependence in the United States. "Sparing a Few Minutes for Tobacco Cessation" and "Tobacco Cessation at Greenwich Hospital" (December 2004) offer helpful strategies to bridge the gap with evidence-based practice and tobacco cessation. With limited resources in today's health care, it's increasingly important for nurses to know how to quickly access the latest evidence when taking care of tobacco-dependent patients and their families. Despite our best efforts, too many opportunities for intervening with smokers are missed. At the very least, nurses can ask the question, advise about the health effects, assess readiness to quit, and refer patients for help. The Joint Commission on Accreditation of Healthcare Organizations now requires that all patients admitted with myocardial infarction, community-acquired pneumonia, or heart failure be assessed for tobacco dependence and receive appropriate counseling. 1 It's imperative that all of us take this public health issue very seriously and look for opportunities to integrate tobacco prevention and tobacco cessation in everyday clinical practice and in nursing curricula.

Janie Heath, PhD, APRN, BC

Washington, DC