A model nurse practitioner-managed smoking cessation clinic.

PURPOSE/OBJECTIVES: To describe an intensive nurse practitioner (NP)-managed smoking cessation clinic that evolved from a primary-care quality-management initiative. DATA SOURCE: Published articles, abstracts, books, clinical experience, and clinical data. DATA SYNTHESIS: Smoking continues to be the leading cause of preventable deaths in the United States and accounts for 87% of all lung cancers. Although smoking is responsible for nearly 30% of all cancer deaths, smoking prevalence rates remain stagnant in adults and are continuing to increase in adolescents. Twenty-five percent of all Americans smoke. An NP-managed clinic was developed within a large teaching hospital located in the southeastern United States based on the Agency for Health Care Policy and Research guideline for smoking cessation. The clinic provided effective smoking cessation interventions that can be replicated by experienced nurses with a smoking cessation background. All nurses have opportunities to assist patients to stop smoking through brief counseling and minimum interventions. CONCLUSIONS: Nurses can effectively manage an intensive smoking cessation clinic that is utilized by the interdisciplinary team to treat referrals. Cessation rates were high because therapies combined intensive behavioral sessions and pharmacologic approaches rather than either single modality. IMPLICATIONS FOR NURSING PRACTICE: Nurses can replicate this practice in a variety of healthcare settings. Innovations in clinical practice often facilitate research studies to further define effective approaches for smoking cessation. Nurses need to identify and target smoking as the serious health problem it is and conduct much-needed research on cessation approaches within the inpatient and outpatient settings.