Training nurses to deliver evidence-based brief interventions for tobacco use and dependence

Tobacco use is the leading cause of preventable death in the US. Tobacco cessation has immediate and major health benefits. Nurses have an extensive reach into the tobacco using population and are vital to the delivery of tobacco cessation services. The evidence-based Public Health Service (PHS) Clinical Practice Guideline for the Treatment of Tobacco Use and Dependence (Fiore, 2000) provides recommendations that can be implemented in busy clinics with minimal demands on providers, can increase patient quit rates, are highly cost effective, and should be part of the routine care of every patient at every visit. However, nurses as well as other healthcare providers, are poor at implementation and rarely provide sufficient assistance with cessation. Providers report a number of barriers to performing these interventions including lack of knowledge, awareness, self-efficacy, and positive outcome expectancies. Training is demonstrated to address these barriers and increase the frequency of provider intervention behaviors. From January 2006 to January 2007, 192 nurses completed a 1-hour CE-approved training. The nurses were administered a pre-test prior to training and a post-test immediately after training with all answers reported on a scale of 0-10 with 0 =“None” and 10 = “Most Ever.” Paired-samples t-tests compared pre- and post-test responses. Training resulted in significant increases in a) motivation, b) knowledge, and c) confidence, as well as perceived d) importance, e) effectiveness, f) importance of barriers, and g) preparedness (all p.s <.01). Nurses who participated in the brief training demonstrated positive improvements in the factors known to be related to performing the PHS guideline interventions. Because tobacco use is one of the largest public health problems in the US and this brief training is likely to increase the frequency with which patients are offered assistance with cessation, this minimal 1-hour training should be broadly disseminated among nurses. Detailed information about the training, the evaluation, and the trainees will be provided.