In this 21st century nurses are alert to healthcare costs and how taxed the healthcare system becomes year after year. Providing smoking cessation education to patients especially the elderly is known to increase quitting rates which “decreases premature mortality and tobacco-related health care costs in the short term” (Department of Health and Human Services, Centers for Disease Control, 2007). Tobacco cessation interventions and treatments have been known to be more cost-effective than other secondary preventative services such as colon screenings, mammography, pap smear tests, some treatments for hypertension and high cholesterol (Department of Health and Human Services, Centers for Disease Control, 2007).

Nurse’s role in patient education

There is a gap in knowledge and practice related to the nurse’s role in educating elderly patients about smoking cessation. There is a lack of evidence-based nursing interventions for cessation practices specifically targeting the elderly. (Health & Jeannette, July/August 2006). Professional nurses need to integrate evidence-based recommendations for smoking cessation and incorporate them in practice in order to carry out successful interventions.

The Massachusetts Department of Public Health has created a program to identify and treat patients who smoke, both in the inpatient and outpatient settings called “QuitWorks” The goal of this program is to provide healthcare providers with cessation resources for their patients who want to quit smoking. This program offers providers with many different avenues that facilitate smoking cessation, such as tools to identify smokers, communication techniques to help intervene with smokers and treatment options, help lines that provide telephone counseling, and patient education materials. The QuitWorks program shows that participants are, “90% satisfied with the services and assistance received both from the Helpline and from the health care provider who enrolled them in the program” (QuitWorks, 2000-2007). As a result of the program, “86% said their health care provider increased their level of motivation to quit, thus reinforcing the significance of the provider-patient relationship in the successful quit smoking process” (QuitWorks, 2000-2007).

Research conducted by Roberts a nurse practictioner specializing in patients with COPD and other respiratory disorders discusses the role of nurses in smoking cessation and helped develop the concept of a “30 second approach” (Roberts, 2002). A group of nurses and primary care physicans collaborated to form a group promoting smoking cessation called, Smoking Cessation Action in Primary Care. This group created a tool that involves three smoking related questions. The questions are given to all patients as a screening tool. The purpose of the tool is to identify patients who may or may not be motivated to quit smoking. If they are found to have motivation to quit, the proper referrals can be made for smoking cessation. The goal is to identify and help treat patients who want to quit smoking in an effcient timely manner without wasting the time of the practitioner and patient (Roberts, 2002).

       
Conclusion

      Professional nurses need to be knowledgeable about smoking cessation practices and integrate them into their care of the elderly. By the year 2030, “it is estimated that 20% of Americans will be 65 years of age or older” (Smeltzer et al. 2008), one of the fastest growing populations. Nurses are among the largest population of healthcare workers that provide direct patient care. Nurses should be aware of resources that can be used to teach elderly patients about disease prevention and health promotion. Elderly patients benefit from smoking cessation practices therefore the professional nurse should target this population in order to improve their health outcomes. Intergrating smoking cessation education in direct patient care within the elderly population will help to addess the growing health disparities effecting the elder population. 
 
 
Bibliography
 

Cataldo, J. K. (August 2007). Clinical implications of smoking and aging. Journal of Gerontological Nursing , pgs.32-41.

Centers for Disease Control and Prevention (CDC). (2007, May 8). Retrieved October 25, 2008, from Smoking and Tobacco Use: http://www.cdc.gov/tobacco/index.htm

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