Nurses Lead the Battle Against Tobacco Use

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Since 1974, the International Council of Nurses (ICN) has celebrated International Nurses Week. In 2012, the week runs from May 6 through May 12 — the birthday of Florence Nightingale.

This year’s ICN theme is “Closing the Gap: From Evidence to Action,” a timely theme for nurses fighting tobacco use. According to the World Health Organization, evidence shows tobacco use is the leading cause of preventable disease and death in the world.

A study by the ICN says that nurses deliver 90 percent of health care services. Nurses’ position on the frontline of health care gives them a unique opportunity to have a direct impact on people who use tobacco products.

We asked nurses: What can you do to lead the battle against tobacco? Join the conversation by adding your comments at the end of this post.


Nurses can lead in the global battle against tobacco by standing up against the tobacco industry and helping the public understand that this is an industrially created disease epidemic.

The public trusts nurses to tell the truth, and learning the truth about what the tobacco companies have done helps motivate smokers to quit and deters youth from becoming the next generation of profit-fodder for an industry still promoting the single most deadly consumer product ever made.

Ruth E. Malone, RN, PhD, FAAN
Professor and Chair, Department of Social & Behavioral Sciences
Core Faculty, Institute for Health Policy Studies and
Center for Tobacco Control Research & Education
University of California, San Francisco


  1. Education. Ensure there is adequate content in the nursing curriculum so that nurses are educated when they are young about tobacco control and smoking cessation. Professional training for practicing nurses is also needed.
  2. Research. Generate evidence on nurses’ interventions (be they brief or intensive!) that can help smokers quit and disseminate such evidence to the professional and lay community. Publish articles in scientific journals.
  3. Clinical practice. Nurses can integrate smoking cessation advice into their everyday clinical practice.
  4. Policy and advocacy. Nurses can influence policy on tobacco control with their evidence (from research) and their voice (as a strong and credible professional group) to support the government or health bureau in tobacco control policies.

All the above should apply to both smoking and secondhand smoking!

Professor Sophia Chan, PhD, MPH, MEd, RN, RSCN, FFPH, FAAN
Professor in Nursing and Director of Research, School of Nursing
Assistant Dean, External Relations
Li Ka Shing Faculty of Medicine
The University of Hong Kong


Children’s exposure to secondhand smoke is preventable and is a public health challenge for all nurses globally.

Children across the world are suffering from illnesses caused by their exposure to secondhand smoke in their homes and communities. Illnesses, such as asthma and otitis media, can seriously reduce the life chances of our children.

Children’s exposure to secondhand smoke mostly occurs in their own home, so nurses are in a unique position to support parents to create a smoke-free home because of their special relationship and access to parents and children.

An innovative smoke-free home intervention in Scotland — REFRESH: Reducing Families Exposure to Second-hand Smoke in the Home — is showing promising results. A “how-to guide” for health professionals has been informed by the findings and more information can be obtained from the REFRESH website.

Dr. Deborah Ritchie
Nursing Studies, University of Edinburgh
Deborah.Ritchie@ed.ac.uk


There are many nurses who have knowledge and experience in working with tobacco control and smoking cessation. We need to be able to collaborate and reach out to those nurses for whom this subject is new, which is why a Global Nurses Network is being formed.

The first task is to support nurses from all over the world to understand the danger posed by people’s tobacco use and be taught how to work with this topic.

Nurses have tremendous reach and influence and make a huge difference in the lives of the people they work with.

The number of tobacco deaths predicted could be reduced if the 12 million nurses working worldwide opportunistically asked all their contacts who use tobacco what they have heard about the risks, as well as provide accurate information of the dangers and health benefits of quitting. This is the place nurses have to start if they are to join the battle against needless tobacco deaths.

Jennifer Percival
Tobacco Policy Advisor
Royal College of Nursing, U.K.


In order for the nursing profession to add their many numbers and their might to the fight against tobacco, we will need to address two critical barriers:

  1. Lack of knowledge and skills. Educational efforts and resources are needed to build capacity so that new nurses joining the profession, as well as practicing nurses, are prepared to actively address tobacco control.
  2. Smoking among the profession. Smoking among health care professionals affects nurses’ health and their interactions with patients and is a critical barrier to tobacco control in many parts of the world.

Resources are critical to support nurses’ quit efforts, and ensuring that nurses are tobacco-free role models is a goal for the profession.

Linda Sarna, DNSc, RN, AOCN, FAAN
Professor and Lulu Wolf Hassenplug Endowed Chair, School of Nursing
Vice Chair/Chair-Elect, Academic Senate, University of California, Los Angeles


At this International Nurses Day (12 May 2012), the International Council of Nurses calls all nurses and nursing organizations to close the gap from evidence to action.

The over 19 million nurses worldwide can make a significant contribution to closing this gap by embracing tobacco control and supporting the policies proposed by the evidence-based WHO Framework Convention on Tobacco Control.

From applying evidence to their daily practice through interventions for tobacco use cessation and promotion of smoke-free environments to urging policymakers to pass strong tobacco control legislation, nurses must use their power to curb the leading cause of preventable death in the world.

As never before, nurses have the evidence, have the voice, and now need to take decisive action to lead the global fight to stop the tobacco epidemic.

Stella Aguinaga Bialous, RN, DrPH
Senior Consultant, Tobacco Policy International