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Developing Smoking Interventions in Nursing

  • Hannah Burrell-Davis

Regulatory and legal documents are essential for appropriate medical practice and affects the way nurses work on a daily basis. The Medical council of New Zealand's code of do and the smoke-free environments function 1990 are types of these, having huge influences on the way nurses practice today. It's important to reflect on how these may affect the medical practice in New Zealand.

The Smoke-free Environments Work 1990 was established to assist in the safety of those people who do not need to smoke or be around second hand smoke in order to avoid any detrimental results to their health. The smoke-free conditions action solidifies this by ensuring that those that do smoke do not inflict any health implications on those who do not smoke themselves, this is made certain by reducing the amount of tobacco substances exposed to non-smokers, and enough rules and control of the advertising and campaign of tobacco products. This is successfully achieved through the sponsoring of other products, happenings or services and/or immediately. Another reason for the smoke-free conditions take action is to ensure that the occurrence of unsafe constituents in tobacco products and tobacco smoke is monitored and regulated. Finally, a health sponsorship council needs to be established, which will assist in promoting health and encourage healthy standards of living (Smoke-free Environments Take action, 1990). The smoke-free surroundings act is broken into 2 parts to assist the quantity of tobacco use and its harmful results, these parts include having smoke-free workplaces and general population areas, and control of smoking products. These two parts are centred on the safeguard of individual's health and reducing the quantity of children that is impacted by second hand smoke.

The Medical Council New Zealand (NCNZ) contains the responsibility for the subscription of nurses; it serves by guarding the protection and health of the city and community by ensuring that nurses are qualified and fit to practice. The NCNZ has many methods and guidelines set in destination to maintain this and fulfil this function, one of these being the NCNZ Code of Carry out. The Code of Do should be employed by nurses to uphold appropriate behavior, not only in the professional role, but must continue to have a high standard of behaviour in their personal lives. That is primarily because nurses must gain the trust of the public. The Code of Do has a couple of values and ideas that are essential for nurses to comprehend, they also aid in the understanding of professional practice and can be employed in association with the Smoke-Free Surroundings act. The ideals in the NCNZ Code of Carry out include value, trust, collaboration and integrity. Esteem is a major value that should be very noticeable in nursing practice, as the code of conduct suggests, dealing with others with esteem means behaving towards people with worth and esteem for their health and wellbeing (NCNZ, 2012), this is essential for a nurse to comprehend. It's not only essential for the nurse to understand during medical practice, it's important to understand in personal life situations, in regards to smoking a smoker must have value for individuals who do not smoke cigarettes or desire to be around carbon monoxide smoke, this includes the health professionals that do smoke.

Encouraging the reduced use of cigarette is a skill that can be quite effective in the medical practice, with smoking cessation however support from the nurse is vital. Along with trust, admiration, integrity and relationship, as the code of conduct implements, support is another very powerful treatment that must be applied in nursing practice, in particular as it pertains to successful smoking cessation. Nicotine craving is a major contributor to most of the withdrawal symptoms, these can be hard to deal with and fear of the unknown is paramount, hence the value for support. At this time a referral to nicotine areas, lozenges and gum will help the withdrawal symptoms. Support can include providing reassurance to the patient, reinstating that there is help available and reminding them that is the first step of treatment to gain the health of them and their family/whanau bordering them. It is also important that the nurse considers this, gender, disabilities/disorders and cultural group of the attempting to quit smoking. Here the nurse would implement the worth and principles in the code of conduct, doing this by ensuring that their practice is culturally safe. The code of conducts rule, relationship, can be utilised at this stage as nurses must also work alongside patients during the smoking cessation process, it is important that patients receive enough information about quitting in a fashion that they can understand in order to make the best choice about their treatment and treatment(NCNZ, 2012).

This can be employed to nursing situations, as the take action outlines that smoking in workplaces is prohibited, this consists of health care configurations, such as private hospitals, community health services, hospices, dental surgeries, aged attention services etc. However although smoking in workplaces is prohibited, as mentioned in the smoke-free surroundings act (Smoke-free Environments Take action, 1990), people, including medical researchers continue to smoke in such areas. The Waikato Times writer Maryanne Twentyman recorded an article in which the Te Aroha District Community Medical center was scrutinised for such anti smoke-free behavior. Te Aroha 69 year old man was a patient when he spent two times at Te Aroha Area Community Hospital, and although he could not fault the medical health care he received, he was surprised and disgusted with the lack of smoke-free insurance policies on a healthcare facility grounds. He suggests "I got appalled to start to see the staff puffing up a surprise close to a healthcare facility entranceways" (Twentyman, 2012). Smoking near the entranceways can be bad for the patients, people can walk through the smoke cigars and the smoke can waft in to the rooms, placing the patients at risk, which can be an example of nurses not pursuing through on the NCNZ Code of Conduct's ideals and concepts and the smoke-free surroundings act by not having the patients' health at best interest. To prevent this from taking place the act areas that there should be dedicated smoking rooms in clinic care institutions and these must be prepared with a mechanical ventilation system. Appropriate and acceptable nursing practice must always be aware of the impacts they or others have on the patient's health.

Another key requirement of the smoke-free conditions act is to prevent young people from being affected by seeing other folks smoke, particularly in homes and colleges. (Smoke-free Environments Take action, 1990). This may strongly be influenced by nursing practice, specifically by community nurses. Rowa-Dewar and Ritchie (2014), claim that children are especially sensitive to second-hand smoke cigarettes (SHS) and the chance associated with it, due to their faster breathing rate, they breathe in more pollutants per their weight than people. What some parents might not exactly be familiar with is the fact that SHS lingers in the air long following the cigarette has been extinguished, and children will still be exposed to the chance it requires. Community nurses are distinctively located to intervene in such health behaviours in the house setting up. Community nurses can use such useful strategies concerning educate and build upon the value of parental desires to protect their children. It is hopeful that this desire will point out the interdependence of their health behaviours and exactly how this might impact their child's health. Matching to Rowa-Dewar and Ritchie (2014) most parents are stunned by the levels of SHS in their own homes and want to protect their children. However the smoke-free environments act has no influence within the smoking environment of the home, it certainly exercises to the alternative young people's surroundings, such as academic institutions, early youth education and treatment centres. Based on the act no individuals are to smoke in any parts of these premises at any time of any day, including the entrances.

Smoking cessation is considered to be a significant factor that nurses can have a strong influence over, not only will it affect the fitness of themselves and their encompassing family/whanau, it can have a huge effect on disabilities, health issues and even such accidental injuries as bone fractures. Whenever a fracture occurs, it is essential that the healing up process begins as soon as possible; this is because delayed fracture recovery can have a significant effect on a patient's wellbeing. However such factors that can bring about a potential hold off includes smoking. All the elements that are in tobacco smoke are associated with the impairment of fracture therapeutic, as a mixture they inhibit the conditions necessary for a well-timed fracture restoration, with nicotine being accepted as a risk factor for reduced bone density. (Miller, 2014). The smoke-free conditions act has a purpose to reduce the harmful effects of cigarette use on people, nurses have the energy to impact smoking habits and the continuance and encouragement of smoking cessation should be present.

Smoking is implicated in various detrimental health effects and many diseases and disabilities. Nurses have a major role in aiding in the reduced use of tobacco smoking and therefor a rise in health worldwide. Such bits of legislation as the Smoke-free Conditions Act and the New Zealand Nursing councils code of carry out, continue to develop and impact on the nursing care and attention that is received today, pushing nurses to offer their best medical practice to diminish serious health complications.


Miller, S. (2014). How Smoking can Hinder Fracture Curing. Journal of Disaster Medical, 22(4), 28-30.

Rowa-Dewar, N. , Ritchie, D. ( 2014). Guarding Children from Smoking in the house: An Ethics of Treatment Perspective. English Journal of Community Medical, 19(5), 214-218.

Smoke-Free Environments Take action, No. 108. (1990). Retrieved from http://www. legislation. govt. nz/act/public/1990/0108/latest/DLM223191. html

The Medical Council of New Zealand. (2012). Code of Carry out for Nurses. Wellington, New Zealand: Medical Council of New Zealand.

Twentyman, M. (2012, January 25). Smoking near hospital gates disgust patient. Waikato Times, p. 24.

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