At the Interagency Committee on Smoking and Health meeting held at Howard University in 2004, the United States Surgeon General Dr. Richard Carmona stated, "Tobacco use remains the leading preventable cause of death and disease in the United States and continues to pose a formidable challenge to the public health community."1 He repeated this message to nurse practitioners (NPs) attending the American Academy of Nurse Practitioners 21st Annual Conference in Grapevine, Texas this June. He stressed the role of primary care providers in making health promotion and disease prevention a priority in their practices and urged that they send a persistent and clear message to private citizens that they as individuals have a personal responsibility and accountability for their current and future state of health.
The national burden of chronic disease care and the resultant suffering and poor quality of life for those affected are reducible, but more importantly, preventable if people start making healthier lifestyle choices. The decision not to smoke or to stop smoking is one of the most significant choices a person will ever make. Dr. Carmona's motivational speech and personal testimony portrayed sincerity and caring as the primary physician for the nation's people.
A Major Health Concern
The effects of long-term smoking are well-documented. This month's CE article on chronic obstructive pulmonary disease (COPD) attributes smoking as a major contributing factor to the development of this condition. Watching someone struggle to breathe because his or her lungs do not function adequately evokes a feeling of helplessness in NPs that is hard to describe.
Healthy People 2010 (http://www.healthypeople.gov/) identifies tobacco use as one of 10 Leading Health Indicators that reflect the major health concerns in the United States at the beginning of the 21st century. Indicators were selected on the basis of their "ability to motivate action, the availability of data to measure progress, and their importance as public health issues." Objective #27 is to reduce illness, disability, and death related to tobacco use and exposure to second-hand smoke.
Public Education is Key
The ban on smoking in public places in many cities across the country is a major achievement toward prevention of chronic respiratory disease. The detrimental effects of second-hand smoke to nonsmokers, and especially young children, are also well-documented in the literature. Smokers do not have the right to expose others to toxins from cigarettes and other tobacco products. Nonsmokers do have the right not to be exposed to second-hand smoke. Ideally, within the next few years, every city in every state will have adopted laws banning smoking in every public place.
Public education about the harmful effects of smoking includes preventing nonsmokers from starting and supporting smokers in efforts to quit. Nurse practitioners are fighting side-by-side with citizens' groups that have advocated for a cleaner environment and healthier air for all to breathe and with other health professionals that work to create the highest quality of life for their patients.
Jamesetta Newland, PhD, APRN, BC, FNP, FAANP, FNAP, Editor-in-Chief
[email protected]
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