Training Psychiatrists and Advanced Practice Nurses to Treat Tobacco Dependence

Abstract

The lack of availability of continuing medical education programs on tobacco dependence for psychiatrists and psychiatric nurses is profound. We developed a 2-day curriculum delivered in November 2006 and March 2007 to 71 participants. Ninety-three percent ( n = 66) completed a pretest/posttest, and 91% (n = 65) completed the attitudes and beliefs survey. Scores on the pretest were low (M = 47% correct). Paired t tests found significant increases in raw scores from 6.7 to 13.6, t(65) = -22.8, p < .0001. More than 90% of psychiatrists and nurses indicated that motivating and helping patients to stop smoking and discussing smoking behavior were part of their professional role. Although 80% reported that they usually ask about smoking status, fewer reported recommending nicotine replacement (34%), prescribing pharmacotherapy (29%), or referring smokers to a telephone quit line (26%). Trainings are repeated twice a year because of ongoing demand. Further follow-up should evaluate changes in practices after training.

Evaluation of the CHOICES Program of Peer-to-Peer Tobacco Education and Advocacy

“…Most mental health centers do not provide tobacco treatment and most tobacco treatment programs do not target people with mental illnesses. Changing the behavior of mental health professionals has had limited success in addressing tobacco as evidenced by the continued low rates of nicotine dependence diagnosis and treatment planning (Peterson et al 2003;Thorndike et al 2001;Williams et al 2009). This is despite recommendations published more than decade ago for psychiatrists to treat tobacco in all their smoking patients (APA 1996).…”

Confronting a Neglected Epidemic: Tobacco Cessation for Persons with Mental Illnesses and Substance Abuse Problems

“…Rather than complicating recovery, participation in smoking cessation efforts while engaged in other substance abuse treatment is associated with a 25% greater likelihood of long-term abstinence from alcohol and other drugs (95,102), and tobacco cessation does not appear to adversely effect mental health treatment (5,81). Yet, substance abuse and mental health providers seldom offer smoking cessation services (54,55,132).…”

Making a Case for Systematic Integration of Theory-Based Tobacco Education Into Graduate Psychiatric/Mental Health Nursing Curriculum

“…The lack of tobacco education and the resulting absence of tobacco related knowledge act as barriers to the provision of effective cessation interventions (Amole, Heath, Joshua, & McLear, 2012;Essenmacher et al, 2008;Ratschen, Britton, Doody, Phil, LeonardiBee, & McNeill, 2009;Sharp et al, 2009;Sheffer, Barone, & Anders, 2010;Williams et al, 2009). Mental health professionals, including psychiatric nurses report that their graduate education did not adequately prepare them to provide tobacco treatment, and many suggest that postgraduate training opportunities are too limited, and when available, too time consuming .…”

“…Most nurses, across all specialties, share the common belief that more needs to be done to assist patients in their efforts to stop smoking, and that tobacco cessation counseling is a vital component of their professional role (Chan, Sarna, Wong, & Lam, 2007;Essenmacher et al, 2008;Hall, Vogt, & Marteau, 2005;Sharp et al, 2009;Williams et al, 2009). Yet there remains a substantial minority who maintain negative beliefs and attitudes about tobacco treatment (Hall et al, 2005).…”