SPECIAL SESSION: Nurses and Tobacco Control: An Intersection of Research and Health Care Policy

Description/Overview: This presentation will highlight the evolution and intersection of an international program of research in lung cancer and tobacco control as model for changing nursing practice and health care policy. Dr. Sarna’s initial program of research focused on the quality of life and symptoms experienced by patients with lung cancer, the leading cause of cancer death worldwide. Dr. Sarna was one of the first to publish about the quality of life concerns experienced by women with lung cancer, the leading cause of cancer death among women in the U.S. since the mid 1980’s, and about issues faced by lung cancer survivors. Tobacco use, rarely routinely collected in nursing research at the time, emerged as a variable impacting symptoms and quality of life. Tobacco use is the leading cause of preventable death and the one risk factor that cuts across all four noncommunicable diseases (NCDs) targeted by the United Nations for global action. Although evidence-based interventions for tobacco dependence treatment are available, they are underutilized by health care providers. After surveying barriers that nurses reported in supporting tobacco control, four major areas were identified: 1) limited knowledge and skills about the problem; 2) limited nursing leadership, 3) limited nursing scholarship, and 4) smoking among nurses. Dr. Sarna addressed these barriers through her research and advocacy, especially through the Tobacco Free Nurses initiative. She helped to shape policy about the role of nurses in tobacco control with nursing organizations, including the American Nurses Association, the Oncology Nursing Society, the International Society of Nurses in Cancer Care, the International Council of Nurses; and multidisciplinary groups, including the American Society of Clinical Oncology, the Institute of Medicine, the National Cancer Institutes, and the World Health Organization (WHO). She has surveyed tobacco-related content in schools of nursing in the U.S. and Asia and tested educational interventions to grow capacity among nurses in the U.S., China, the Czech Republic and Eastern Europe. She has promoted nursing research in the field and published a synthesis in an Annual Review of Nursing Research. In collaboration with the WHO she co-authored a monograph about strategies to enhance the nurses’ role in addressing NCDs which helped to influence nursing policy. Nurses contributed to the knowledge and understanding of the dangers of smoking among women through participation in the Nurses’ Health Study (NHS), the largest and longest running study of women’s health in the world. Dr. Sarna’s analysis of data from the NHS described the impact of smoking on female nurses’ survival and quality of life. She monitored smoking among health care professionals using the Current Population Supplement-Tobacco Use Supplement, published in a special issue of JAMA focused on the 50th anniversary of the Surgeon General Report on smoking and health. Dr. Sarna also has provided leadership in policies surrounding exposure to secondhand smoke. She lead the efforts to create a tobacco-free campus at UCLA; and co-authored a resolution from the American Academy of Nursing for all schools of nursing to be tobacco-free.