Smoking cessation education: An evaluation of nursing practices in hemodialysis care

Introduction: Smoking cessation is a primary objective for patients undergoing hemodialysis. The aim of this study was to assess the tobacco consumption of hemodialysis patients, the smoking cessation education they received, and the barriers and facilitators encountered by dialysis nurses in implementing these types of interventions.

Method: This study examined the practices used to monitor the smoking status of hemodialysis patients, as well as nursing education activities related to cessation in clinical practice. It is based on an epidemiological survey and a method akin to clinical auditing. Results: Of the 734 patients that responded to the epidemiological survey, 17% were smokers. Only 14% of smoking patients who benefited from smoking cessation education had it delivered by a nurse. Active smoker status was indicated in 20 of the 38 electronic medical records of the smoking patients audited (52%). The themes that emerged from the 10 nursing interviews carried out were: smoking cessation as a taboo subject; the fragmentation of specialties in medicine; a lack of awareness regarding the right to prescribe nicotine replacement therapy (NRT); and differences in nurses’ perception of their own role. Discussion: Nurses are in a key position to help reduce smoking rates, but broaching the topic remains difficult: dialysis sessions are not always seen as appropriate moments for intervention, and there is a lack of training and knowledge on smoking and the prescription of NRT.