Evaluation of Tobacco Cessation Classes Aimed at Hospital Staff Nurses

Pamela Matten

Victoria Morrison

Dana N. Rutledge

Timothy Chen

Esther Chung

Siu-Fun Wong

smoking cessation, self-care
ONF 2010, 38(1), 67-73. DOI: 10.1188/11.ONF.67-73

Purpose/Objectives: To evaluate a three-hour smoking cessation program and its effect on nurse knowledge, counseling behaviors, and confidence in counseling behaviors.

Design: Program evaluation.

Setting: A Magnet®-designated, 500-bed community hospital in Southern California.

Sample: 107 nurses.

Methods: Program content included behavior counseling and pharmacotherapy along with role playing. Investigator-developed self-report surveys were completed on the day of the class and at 3, 6, and 12 months.

Main Research Variables: Short- and long-term changes in nurse knowledge, attitudes, and behaviors about tobacco cessation efforts.

Findings: Knowledge significantly increased from baseline to post-test. Counseling skills improved. Nurses who completed all surveys exhibited no significant changes about asking patients to quit smoking but did demonstrate significant changes at three months regarding advising patients, assessing quit readiness, and providing assistance. Changes were maintained over the year. Nurses' average ability to counsel patients was rated "good or very good" after one year. At 3, 6, and 12 months, most respondents reported providing cessation counseling or referrals to at least one patient.

Conclusions: These findings support tobacco cessation programs for bedside nurses as useful in enhancing nurse confidence in patient-counseling skills.

Implications for Nursing: Study findings demonstrated benefits to using the developed curriculum. Additional research is needed on tobacco cessation programs for hospital nurses, particularly with longitudinal outcomes and actual nurse behaviors.

Jump to a section


    Bialous, S. A., Sarna, L., Wewers, M. E., Froelicher, E. S., & Danao, L. (2004). Nurses' perspectives of smoking initiation, addiction, and cessation. Nursing Research, 53, 387-395.
    Borrelli, B., Lee., C., & Novak, S. (2008). Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses. Preventive Medicine, 46, 358-363. doi: 10.1016.j.ypmed.2007.09.001
    Bryant, S. K. (2008). Smoking cessation strategies by nurses in an acute care setting. Journal for Nurses in Staff Development, 24, 31-35. doi: 10.1097/01.NND.0000300849.35340.60
    California Department of Health Services. (2007). Help your patients quit smoking. Retrieved from
    Carlebach, S., & Hamilton, S. (2009). Understanding the nurse's role in smoking cessation. British Journal of Nursing, 18, 672-676.
    Chan, S. S., Sarna, L., Wong, D. C., & Lam, T. H. (2007). Nurses' tobacco-related knowledge, attitudes, and practice in four major cities in China. Journal of Nursing Scholarship, 39, 46-53.
    Corelli, R. L., Kroon, L. A., Chung, E. P., Sakamoto, L. M., Gundersen, B., Fenlon, C. M., & Hudmon, K. S. (2005). Statewide evaluation of a tobacco cessation curriculum for pharmacy students. Preventive Medicine, 40, 888-895. doi: 10.1016/j.ypmed.2004.10.003
    Deckter, L., Mahabee-Gittens, E. M., & Gordon, J. S. (2009). Are pediatric ED nurses delivering tobacco cessation advice to parents? Journal of Emergency Nursing, 35, 402-405. doi: 10.1016/j.jen.2007.10.018
    Fiore, M. C., Bailey, W. C., Cohen, S. J., Dorfman, S. F., Goldstein, H. G., Gritz, E. R., … Wewers, M. E. (2000). Treating tobacco use and dependence. Clinical practice guideline. Retrieved from
    Hudmon, K. S., Corelli, R. L., Chung, E. P., Gundersen, B., Kroon, L. A., Sakamoto, L. M., … Prokhorov, A. V. (2003). Development and implementation of a tobacco cessation training program for students in the health professions. Journal of Cancer Education, 18, 142-149.
    Katz, A., Goldberg, D., Smith, J., & Trick, W. E. (2008). Tobacco, alcohol, and drug use among hospital patients: Concurrent use and willingness to change. Journal of Hospital Medicine, 3, 369-375. doi: 10.1002/jhm.358
    Kelley, F. J., Heath, J., & Crowell, N. (2006). Using the Rx for Change tobacco cessation curriculum in advanced practice nursing education. Critical Care Nursing Clinics of North America, 18, 131-138. doi: 10.1016/j.ccell.2005.11.003
    Kviz, F. J., Clark, M. A., Prohaska, T. R., Slezak, J. A., Crittenden, K. S., Freels, S., & Campbell, R. T. (1995). Attitudes and practices for smoking cessation counseling by provider type and patient age. Preventive Medicine, 24, 201-212. doi: 10.1006/pmed.1995.1034
    Lancaster, T., Silagy, C., & Fowler, G. (2000). Training health professionals in smoking cessation. Cochrane Database of Systematic Reviews, 3, CD000214. doi: 10.1002/14651858.CD000214
    McCarty, M. C., Zander, K. M., & Hennrikus, D. J. (2001). Barriers among nurses to providing smoking cessation advice to hospitalized smokers. American Journal of Health Promotion, 16, 86-88.
    Narsavage, G., & Idemoto, B. K. (2003). Smoking cessation interventions for hospitalized patients with cardio-pulmonary disorders. Retrieved from
    Rice, V. H., & Stead, L. F. (2001). Nursing interventions for smoking cessation. Cochrane Database of Systematic Reviews, 3, CD001188. doi: 10.1002/14651858.CD001188
    Sarna, L., Bialous, S. A., Wells, M., Kotlerman, J., Wewers, M. E., & Froelicher, E. S. (2009). Frequency of nurses' smoking cessation interventions: Report from a national survey. Journal of Clinical Nursing, 18, 2066-2077. doi: 10.1111/j.1365-2702.2099.02796.x
    Swallow, A. D., & Dykes, P. C. (2004). Tobacco cessation at Greenwich Hospital. American Journal of Nursing, 104, 61-63.
    University of California Schools of Pharmacy and Medicine. (n.d.). RX for Change. Clinician-assisted tobacco cessation. Retrieved from
    U. S. Department of Health and Human Services. (2004). The health consequences of smoking: A report from the Surgeon General. Retrieved from
    Wewers, M., Kidd, K., Armbruster, D., & Sarna, L. (2004). Tobacco dependence curricula in U. S. baccalaureate and graduate nursing education. Nursing Outlook, 52, 95-101.
    Zarlin, K. K., Burke, M. V., Gaines, K. A., & Gauvin, T. R. (2008). Registered nurse initiation of a tobacco intervention protocol: Leading quality care. Journal of Cardiovascular Nursing, 23, 443-448. doi: 10.1097/01.JCN.0000317451.64778.e9