Nurses and Medications: The Frontline in Helping Smokers Quit

In the ongoing battle against tobacco addiction, nurses and evidence-based medications are emerging as crucial components in smoking cessation programs, particularly in healthcare settings across Spain and globally.

The Role of Nurses in Smoking Cessation

Nurses are at the forefront of this effort, leveraging their unique position to identify and support patients who are ready to quit smoking. The Ottawa Model for Smoking Cessation (OMSC), developed at the University of Ottawa Heart Institute, has been a beacon of success in this area. This model emphasizes systematic, interdisciplinary collaboration, ensuring that all admitted patients have their smoking status identified and documented, and are offered evidence-based smoking cessation assistance[1].

In primary care settings, nurses and other healthcare professionals are trained to follow the "Ask, Advise, Act" model. This involves asking patients about their tobacco use, advising them on the benefits of quitting, and acting to provide the necessary support and resources for cessation. This approach has been implemented in over 200 primary care practices in Ontario, Canada, and has shown significant increases in smoking cessation rates among patients[1].

Evidence-Based Medications and Support

Medications play a vital role in the smoking cessation process. Nicotine Replacement Therapy (NRT), varenicline, and other pharmacotherapies are proven to be highly effective when combined with behavioral support. For instance, the EX Program by Truth Initiative, developed in collaboration with Mayo Clinic, offers multimodal quitting support that includes these medications along with counseling and real-time tracking. This program has demonstrated substantial healthcare cost savings, with participants incurring $950 less in healthcare costs annually compared to non-participants[2].

Challenges and Opportunities

Despite the progress, there are challenges to overcome. In low- and middle-income countries, access to treatment facilities and resources poses significant hurdles. However, integrating smoking cessation programs with existing health services, such as tuberculosis control, can offer viable solutions. The standardization of peri-operative care to include smoking cessation is also feasible even with limited resources[1].

The COVID-19 pandemic has accelerated the adoption of virtual care and digital tools in smoking cessation. For example, the Ontario initiative in Canada has seen widespread use of virtual care and digital education prescriptions to support patients in quitting smoking. This approach has been particularly effective in cancer treatment settings, where continued smoking after a cancer diagnosis can lead to worse clinical outcomes[1].

Global Initiatives and Impact

Global networks, such as the Global Network for Tobacco-Free Healthcare Services, are facilitating action on effective tobacco management and cessation policies within healthcare services worldwide. These initiatives emphasize the importance of making smoking cessation an integral part of healthcare, especially in cancer treatment centers. The Cancer Center Cessation Initiative (C3I) in the USA, part of the National Cancer Institute's Cancer Moonshot program, has also been instrumental in spreading smoking cessation initiatives across major cancer centers[1].

In conclusion, the combined efforts of nurses, evidence-based medications, and innovative support programs are transforming the landscape of smoking cessation. As these initiatives continue to expand and adapt to different healthcare settings, they offer a promising future for reducing the global burden of tobacco addiction and improving public health outcomes. For expats in Spain, these developments highlight the importance of seeking support from healthcare professionals and leveraging available resources to quit smoking and improve overall health.