1. ISO 9001 Registered ASH KAN Assessment of smoking history, knowledge & attitudes of nurses in New Zealand Hayden McRobbie, Clinical Trials Research Unit

2. ASH KAN Team ASH (NZ) supported studentship – Zev Fishman Co-investigators – Grace Wong, AUT and ASH NZ – Professor Bruce Arroll, University of Auckland – Sharon Clair, NZNO – Dr Marewa Glover, ATCRC, University of Auckland – Dr Andrew Jull, CRTU – Becky Freeman

3. Background Nurses have a key role to play in helping smokers to stop Interventions delivered by nurses are effective However attitudes and knowledge towards smoking and smoking cessation can effect provision of advice and treatment

4. Aims To assess the 1.Knowledge of health risks of smoking and benefits of quitting 2.Attitudes towards smoking and smoking cessation 3.Knowledge of smoking cessation interventions

5. Method Postal survey 1000 nurses from the NZ Nursing council register (500 community based 500 hospital based) Questionnaire developed to address the aims Answered on a 5-point scale (1=strongly disagree; 5=strongly agree)

6. Results Response rate: 37% (n=371) Demographics – 95% female – 83% Pakeha – 93% registered nurses – 64% practicing for >15 years – 30% primary health care

7. Smoking status of respondents 25 (7%) were current smokers – Smoked on average of 5 cigs/day – 40% highly dependent – 88% stated that they wanted to quit 35% were ex-smokers

8. Knowledge 91% recognized that most people smoke because of nicotine dependence 97% agreed that people experience withdrawal when they stop High level of awareness of health effects – Lung cancer (100%), heart disease (100%) emphysema (99%), mouth cancer (96%)

9. Knowledge Nicotine is the main product that causes (%agreed) – Cancer (63%) – Heart disease (64%) – Emphysema (63%) 57% knew that tobacco companies typically add a number of compounds to alter nicotine absorption and taste

10. Attitudes about stopping smoking 90% agreed that it was part of their responsibility to advise their patients to stop Barriers (%agreeing) – Lack of time (21%) – Harms nurse-pt relationship (9%) – Lack of efficacy of advice (55%) – Lack of skills (23%) Smoking cessation is the role of primary care (78%)

11. Attitudes about nurses who smoke Statement% agree Nurse responsibility to set a good example by not smoking 82% Seeing a nurse smoking won’t affect a smokers view of smoking 21% A nurses own business to smoke45% Patients less likely to take advice from a nurse who smokes 62%

12. Practice 84% ask about smoking status 80% advise on the risks of smoking 68% advise to quit 71% advise to cut down 39% say that they provide smoking cessation counseling 78% referred patients to Quitline 44% referred to Aukati kai paipa (27% had never heard of this service)

13. Treatments Proven effectiveness Patch (79%) Gum (56%) Inhaler (14%) Microtab (11%) Bupropion (22%) Nortriptyline (8%) Unproven effectiveness Acupuncture (30%) Hypnosis (40%) Nicobrevin (33%) St Johns Wort (4%) (% who believe that treatment is effective) 1% (n=4) thought none were effective treatments 16% did not know

14. Conclusions Nurses have positive attitudes about helping smokers – Giving brief advice – Providing treatment – Enthusiasm to expand knowledge and skills There are some common barriers that need to be addressed – Knowledge of effective smoking cessation interventions, skill, time to deliver treatment Nurses who smoke should be supported to quit (most want to stop)

15. Thank you Nurse Advocacy Group: Nurses for a Smokefree Aotearoa/New Zealand Join at: nurses@ash.org.nznurses@ash.org.nz Or contact Grace Wong at ASH (NZ)