Impact of hospitalisation on patient smoking: current practice and potential for nurse-provided smoking cessation care

Tobacco smoking is currently responsible for the deaths of 50 Australians every day. We have known for a long time that these deaths are preventable, however, the difficulty lies in helping people to overcome their addiction to nicotine, and in preventing young people from taking up the behaviour. The hospital setting has been described in the literature as a "window of opportunity" and a "teachable moment" for providing smokers with encouragement, support and skills to quit smoking while they are in hospital. Nurses have been described as an "underutilised resource" in efforts to control the tobacco epidemic. The nature of the hospital setting differs markedly from that of the general practice setting, where extensive research effort has been focused over the last two decades. The public health research literature offers very little in the way of information about the potential of the hospital setting, or of nurses as providers of smoking cessation care. Therefore this thesis aims to determine the potential of the hospital setting and of nurses as providers of smoking cessation advice, and to inform the development, and appropriate targeting of hospital based smoking cessation interventions in the future. The approach taken follows the steps identified in research models designed to guide the development of health behaviour change research. These models identify the need to have accurate measures of the target behaviour, knowledge of the prevalence of the targeted behaviour, an understanding of the perceptions of the target group towards health behaviour change, including knowledge of risk, attitudes to change and barriers to receiving help. They also stress the need for knowledge of the perceived appropriateness of the intended provider group, their knowledge, attitudes, barriers and skills in providing the health behaviour intervention, and data on the current levels of health intervention, being provided to the target population by these providers.