The 13th World Conference on Tobacco OR Health

Objective: Nurses' report a positive attitude toward providing cessation support; yet, report a practice norm of missed opportunities in addressing patients' tobacco use. A commonly cited reason for not providing cessation support has been insufficient time. To explore the use of time related to addressing tobacco use we combined qualitative data from two studies of hospital-based nurses' integration of cessation interventions. The objective of the secondary analysis was to describe how nurses' time was being used to “manage” patients' tobacco use.

Methods: These studies were conducted at hospitals in two western Canadian provinces and included 16 adult inpatient and 9 inpatient maternity wards. Brief semi-structured interviews were conducted with nurses on these wards (n=85; n=67). Secondary analysis was conducted to identify themes concerning nurses' use of time related to management of patients' tobacco use.

Results: While in the two original studies we were interested in evidence of nurses' attitudes toward providing cessation support, we had not anticipated witnessing how nurses' practice time was being used in relation to patients' tobacco use. Secondary analysis revealed four key themes: enforcing protection regulations, negotiating provision of care, assessing and supporting patients' physiological needs related to leaving the ward to have a cigarette, and maintaining unofficial lists of patients' tobacco use to inform ward routines. Consideration of these examples of time utilization by nurses to manage patients' tobacco use, led us to question the framing of tobacco use as an issue and the resources available for nurses to address patients' tobacco use.