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Top tips for nurses working with smokers

Top tips for nurses working with smokers

Top tips for nurses working with smokers
Public Health England's tobacco control expert offers advice for nurses working with people who smoke.
Encourage your patients to quit with these top tips, exclusively for Nursing in Practice on National No Smoking Day 2014
 1. "Smokers expect to be asked about their smoking by healthcare professionals"
By not raising the issue it may give the impression that smoking is not important or that it doesn’t have a significant impact on the persons health.
There is almost always an opportunity to ask about smoking.
If you are not sure what to say, try phrases such as “Are you a smoker?” or “Do you smoke at all?”; if you have discussed it previously then perhaps consider “How’s it going with the smoking?”, “I see from your notes that you’re a smoker, are you still smoking?”. It may be that the person would like to discuss their smoking and is just waiting for you to ask….
 2. "Talking to your patients about smoking will not negatively impact on your relationship and needn’t take up lots of time"
There is lots of evidence that advice from a healthcare professional can be one of the most important triggers in smokers making a quit attempt.
It is important when discussing smoking that an offer of support or signposting where this can be accessed is also provided. Know where your local Stop Smoking Services and/or trained advisors can be reached so you can direct those interested to the right people as quickly as possible.
 3. "Most smokers say they would like to stop"
If not right now, then at some point in the (near) future. Letting a smoker know what help and support is available may prompt them into taking action or at least to seek out these tools when they decide the time is right to quit. 
 4. "Smokers are up to four times more likely to quit successfully with support and medication"
It is well known that a combination of behavioural support and appropriate use of stop smoking medications can substantially increase the chance of quitting.
Encouraging smokers to access the free and expert help on offer (perhaps within the practice or hospital) through the local Stop Smoking Service will really make a difference.
 5. "Smoking (or being exposed to smoke) during pregnancy can harm the baby"
Most women who smoke will stop smoking as soon as they find out they are pregnant, however, for some this is still very difficult.
Smoking is associated with many serious health issues including low birth weight, miscarriage, sudden infant death and other longer term heath conditions.
Advising pregnant women at every opportunity on why it is important to stop and sign posting support is vital for the care of both mother and (unborn) child.
 6. "Help smokers to prepare for stopping if they don’t want to access other support"
Not everyone will want to take up the offer of additional support, however, there are still some important tips to help them prepare.
Setting a definite quit date and sticking to it, using a stop smoking medication, identifying potentially difficult situations, planning ways to cope if/when temptations to smoke arise and alternative activities as a reward for their hard work will help to give the smoker a better chance of success.
There are also self-help materials, text support or apps that might be useful
 7. "Smokers can take action to reduce the harm associated with smoking, even if they are not ready to stop yet"
Although quitting completely and in one step is the best thing a smoker can do for their health, there are ways lessen the impact if the time is not right to stop.
Using a licensed nicotine product (such as NRT) to help reduce the number of cigarettes smoked, stop temporarily or cut down before quitting can help and may also give the smoker confidence they need to go on and try giving up entirely.
 8. "Free on-line training is available for healthcare professionals" 
The National Centre for Smoking Cessation & Training has a range of training programmes and resources that can be accessed both on-line and for free.
This includes Very Brief Advice on Smoking, Brief Advice on Secondhand Smoke (each 20-30 mins), becoming a fully certified stop smoking advisor (up to six hours, depending on current knowledge) and specialty modules on smoking in pregnancy or smoking and mental health (1-2 hours).
See for more information.
 9. "National campaigns can help trigger quitting – get involved"
There are many national and local campaigns taking place throughout the year.
Materials are often free to order or download and can help engage smokers in the idea of quitting or provide a useful way of starting a conversation. See the Smoke Free website or contact your local stop smoking service for more information. 

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