Virginia Hill Rice

Comparison of cigarette and water-pipe smoking by Arab and non-Arab-American youth.

BACKGROUND Water-pipe smoking is a rapidly growing form of tobacco use worldwide. Building on an earlier report of experimentation with cigarette and water-pipe smoking in a U.S. community sample of Arab-American youth aged 14-18 years, this article examines water-pipe smoking in more detail (e.g., smoking history, belief in harmfulness compared to cigarettes, family members in home who smoke water pipes) and compares the water-pipe-smoking behaviors of Arab-American youth with non-Arab-American youth in the same community. METHODS A convenience sample of 1872 Arab-American and non-Arab-American high school students from the Midwest completed a 24-item tobacco survey. Data were collected in 2004-2005 and analyzed in 2007-2008. RESULTS Arab-American youth reported lower percentages of ever cigarette smoking (20% vs 39%); current cigarette smoking (7% vs 22%); and regular cigarette smoking (3% vs 15%) than non-Arab-American youth. In contrast, Arab-American youth reported significantly higher percentages of ever water-pipe smoking (38% vs 21%) and current water-pipe smoking (17% vs 11%) than non-Arab-American youth. Seventy-seven percent perceived water-pipe smoking to be as harmful as or more harmful than cigarette smoking. Logistic regression showed that youth were 11.0 times more likely to be currently smoking cigarettes if they currently smoked water pipes. Youth were also 11.0 times more likely to be current water-pipe smokers if they currently smoked cigarettes. If one or more family members smoked water pipes in the home, youth were 6.3 times more likely to be current water-pipe smokers. The effects of ethnicity were reduced as a result of the explanatory value of family smoking. CONCLUSIONS Further research is needed to determine the percentages, patterns, and health risks of water-pipe smoking and its relationship to cigarette smoking among all youth. Additionally, youth tobacco prevention/cessation programs need to focus attention on water-pipe smoking in order to further dispel the myth that water-pipe smoking is a safe alternative to cigarette smoking.

Promoting tobacco dependence treatment in nursing education.

ISSUES There are 17.3 million nurses worldwide, the largest group of health-care professionals, and they have great potential to address the epidemic of tobacco use and its related morbidity and mortality. However, the evidence indicates that the educational preparation of nurses for tobacco control remains inadequate. APPROACH This paper provides an overview of the efficacy of nurses in the delivery of smoking cessation interventions, existing tobacco control content in nursing educational programs, model curricula, teaching resources and strategies for reducing barriers to curricular change. KEY FINDINGS Despite the efficacy of nursing intervention for tobacco cessation, lack of appropriate knowledge and/or skill presents a major problem for implementation. An important factor fostering this lack of preparation is limited tobacco control content in current nursing educational programs. Barriers to enhancing and building this curricula include lack of preparation of educators, low priority for this content in an already overloaded curricula, negative attitudes, continued smoking by nursing students and/or faculty and lack of tested curricula. The availability of new tobacco control resources, including those specifically tailored for nurses can assist educators in teaching this content and nurses in implementing interventions. IMPLICATIONS Research and changes in policy are needed to ensure that nursing education includes essential content on tobacco control. CONCLUSION Nurses can be effective in delivering tobacco cessation interventions. Efforts are needed to promote curriculum that ensures that all nursing students and practicing nurses receive tobacco control content and are competent in the delivery of interventions; and to disseminate resources to nursing educators

Nursing intervention and smoking cessation: A meta-analysis

OBJECTIVE To determine with meta-analysis the effects of nursing-delivered smoking cessation interventions. RESULTS Fifteen studies comparing nursing intervention with a control or usual care found intervention to significantly increase the odds of smoking cessation. There was heterogeneity among the study results, but pooling by using a random effects model did not alter the estimate of effect. There was no evidence from indirect comparison that interventions classified as intensive had a larger effect than less intensive ones. There was evidence that interventions were more effective for hospital inpatients with cardiovascular disease than for inpatients with other conditions. Interventions in nonhospitalized patients also showed evidence of efficacy. Nurse counseling on smoking cessation during a screening health check was likely to have less effect. The results indicate the potential benefits of smoking cessation advice and counseling given by nurses to their patients, with reasonable evidence that intervention can be effective.

Predictors of Arab American Adolescent Tobacco Use

This study examined personal, psychosocial, sociocultural, and environmental predictors in tobacco use for 1,671 Arab American adolescents. Cigarette smoking in the past 30 days was 6.9%. This increased from 1% at age 14 to 14% at age 18. Twenty-nine percent of the youths reported having ever smoked cigarettes. Experimentation with narghile was 27%; it increased from 23% at 14 years to 40% at 18 years. All trends were significant (p < .001). Logistic regression analyses found 11 predictors for having smoked a cigarette in the past 30 days and 9 and 7 predictors, respectively, for having ever smoked a cigarette or the narghile. Tobacco use by friends and family members was the strongest predictor of cigarette and narghile smoking. Narghile use supported cigarette smoking.

Intervention Effects on Tobacco Use in Arab and Non-Arab American Adolescents

A quasi-experimental design was used to test a modified Project Towards No Tobacco (TNT) use program on cigarette smoking in 380 Arab American and 236 non-Arab American 9th graders in the Midwest. Tenth grade Non-Arab American students given the intervention as 9th graders were 23% less likely to experiment (Odds Ratio=1.31, 95% CI: 1.05, 1.64) or to have smoked cigarettes in the past 30 days (Odd Ratio=1.43 times, 95% CI: 1.03, 2.01) compared to Arab American youth. Arab American students reported greater experimentation with water pipe smoking than cigarettes (38% vs. 22%), and more current (16% vs. 6%) and regular (7% vs. 3%) use of water pipes than cigarettes, respectively. The intervention designed to focus on cigarette smoking had non-significant effects on water pipe smoking. These findings provide support for a school-based intervention revised to focus on prevention as well as cessation and to be culturally consistent. They also call for further research and intervention tailoring to address the problem of water pipe smoking in a growing Arab American adolescent population.

Predictors of narghile (water-pipe) smoking in a sample of American Arab Yemeni adolescents

To explore the predictors of water-pipe smoking among American Arab Yemeni adolescents, a descriptive correlational design was used, and regression models representing the proposed relationships in the study were tested from a convenience sample of 297 adolescents who attended a teen health clinic and two high schools. The participants completed five measures. Fourteen hypotheses were tested. Experimentation with tobacco was found to be significant in predicting narghile smoking. Tobacco use prevention and cessation interventions for this population can be focused on targeting the family and peer units, from which their identity is likely derived.

Nursing research and treatment of tobacco dependence: State of the science

Tobacco use is considered to be the single most preventable cause of premature morbidity and mortality among men and women. It is well documented that tobacco cessation reduces the burden of disease significantly and is cost effective. Efficacious therapy for tobacco dependence exists, and nurses have been shown to be effective tobacco cessation interventionists. Given the large number of nurses in the United States, nurses can influence national health objectives of reduced tobacco use significantly and help to decrease the number of adults at risk for tobacco-attributable disease and death. The objectives of this presentation are to (a) describe the scientific evidence for tobacco cessation interventions, based on the U.S. clinical practice guideline Treating Tobacco Use and Dependence; (b) present the meta-analytic findings of the efficacy of nursing interventions for smoking cessation; (c) discuss barriers to nursing research and tobacco interventions; and (d) provide future directions for nursing intervention research.

Water pipe smoking among the young: the rebirth of an old tradition.

This article provides information on the growing threat of water pipe smoking (hookah) around the world and in the United States. Historically an activity of Middle Eastern older adults, the most recent growth in water pipe smoking (WPS) has been among adolescents and young adults. Associated with its use is a growing list of health problems. To date no interventions have been specifically designed for this form of tobacco use and they are sorely needed. Nurses must continue to teach No Tobacco Use in any form and that means no water pipe smoking must be part of every health message.

A National Study Links Nurses’ Physical and Mental Health to Medical Errors and Perceived Worksite Wellness

Objective: The aim of this study was to describe (1) nurses’ physical and mental health; (2) the relationship between health and medical errors; and (3) the association between nurses’ perceptions of wellness support and their health. Methods: A cross-sectional descriptive survey was conducted with 1790 nurses across the U.S. Results: Over half of the nurses reported suboptimal physical and mental health. Approximately half of the nurses reported having medical errors in the past 5 years. Compared with nurses with better health, those with worse health were associated with 26% to 71% higher likelihood of having medical errors. There also was a significant relationship between greater perceived worksite wellness and better health. Conclusion: Wellness must be a high priority for health care systems to optimize health in clinicians to enhance high-quality care and decrease the odds of costly preventable medical errors.

Monitoring the tobacco epidemic with national, regional, and international databases and systematic reviews: evidence for nursing research and clinical decision making.

Tobacco use (primarily cigarette smoking) continues to be the most preventable health risk in the United States and the second greatest health threat around the world. In 2020 the global burden is expected to exceed nine million deaths annually. Nursing, with the largest numbers of health care professionals has an opportunity to make a significant reduction in tobacco use through its research and client-focused care. This chapter addresses why and how monitoring the tobacco epidemic with population-based databases and meta-analyses is important for nurse researchers and for evidence-based nursing practice. Population-based surveys permit an examination of trends in tobacco use and the progress in tobacco control with some confidence across time, places (i.e., states, nations, communities, etc.), and large numbers of participants. Included in this review are a description of the numerous national and international databases and other resources that nurse researchers can use to build the science of tobacco use. Additionally, research reviews and meta-analyses are described as other vehicles for providing a basis for making evidence-based decisions about nursing intervention. Nurse scientists have an obligation to use and evaluate these diverse resources to determine the gaps in knowledge, provide a foundation for clinical practice, and identify the needs and directions for future research in the field.