Factors influencing nurses' smoking cessation assessment and counseling practices

Nurses are in a strategic position to influence their patients to stop smoking, but factors affecting their likelihood of assessing and counseling are unknown. The purpose of this cross-sectional survey study was to identify predictors of tobacco use assessment and smoking cessation intervention by office-based nurses employed in private physician practices in Kansas. A 43-item questionnaire was mailed to all family practice, internal medicine, and pediatric private practice offices located throughout the state of Kansas with a final sample of 415 completed surveys. Logistic regression was performed to identify predictors of three dependent variables: (1) tobacco use assessment, (2) patient interest in smoking cessation, and (3) delivering smoking cessation counseling. Nurses were more likely to assess patient tobacco use, assess patient interest in tobacco cessation, and provide tobacco cessation counseling if they believed they had the skills, and had attended tobacco-related continuing education in the previous year. Advanced practice nursing and more years of experience were predictors of assessment activities, but not cessation counseling. Nurses with a bachelor (BSN) degree or higher did provide smoking cessation advice more consistently than non-BSN prepared nurses. Nurses must believe they are sufficiently skilled to overcome perceived barriers to assess tobacco use. Continuing education, skills development and improved understanding of tobacco cessation facts may increase self-efficacy.