Jairath N, Mitchell K, Filleon B
School of Nursing, University of Maryland, Baltimore, MD, USA.
Int Nurs Rev. 2003 Dec;50(4):203-14. doi: 10.1046/j.1466-7657.2003.00198.x.
Tobacco smoking is a major international health issue which nurses are ideally positioned to address. Childhood represents a critical period for intervention to prevent/reduce smoking. During childhood, the majority of smokers first experiment with smoking, are initiated into the smoking subculture and become addicted to tobacco. Children are highly susceptible to smoking as a result of developmental factors, which promote or facilitate high-risk behaviours, limited coping skills, limited defences and inadequate legal protection against youth-focused marketing of tobacco.
This paper is intended to sensitize nurses to the magnitude of childhood smoking as an international health problem and to familiarize them with current intervention approaches and care issues pertinent to child and adolescent populations.
An extensive literature review was conducted to determine the impact of childhood smoking at the personal and community level, characteristics of child smokers, the processes associated with smoking cessation, intervention approaches and intervention models for use by nurses across the spectrum of clinical settings.
Evidence exists that behaviourally based interventions by nurses for smoking prevention/cessation are effective with children. Key components of effective behaviourally based antismoking approaches for smokers include addressing self-efficacy to quit, providing social support, resisting temptation to smoke and discussing issues related to relapse and relapse prevention. For all children, the reinforcement of non-smoking behaviour is essential. Intervention models, which can be incorporated into routine clinical care of individual children or with groups, emphasize the importance of parental involvement, routine screening for tobacco use and provision of a clear message that smoking and tobacco use is unhealthy.
吸烟是一个重大的国际健康问题，护士在解决这一问题方面具有理想的地位。儿童期是预防/减少吸烟干预的关键时期。在儿童期，大多数吸烟者首次尝试吸烟，融入吸烟亚文化并对烟草上瘾。由于发育因素，儿童极易吸烟，这些因素促进或助长了高风险行为、应对技能有限、防御能力有限以及针对以青少年为目标的烟草营销缺乏足够的法律保护。
本文旨在使护士认识到儿童吸烟作为一个国际健康问题的严重性，并使他们熟悉与儿童和青少年群体相关的当前干预方法和护理问题。
进行了广泛的文献综述，以确定儿童吸烟在个人和社区层面的影响、儿童吸烟者的特征、与戒烟相关的过程、干预方法以及护士在各种临床环境中使用的干预模式。
有证据表明，护士基于行为的吸烟预防/戒烟干预对儿童有效。对吸烟者有效的基于行为的反吸烟方法的关键组成部分包括解决戒烟的自我效能感、提供社会支持、抵制吸烟诱惑以及讨论与复发和预防复发相关的问题。对所有儿童来说，强化不吸烟行为至关重要。可以纳入个体儿童或群体常规临床护理的干预模式强调了父母参与、常规烟草使用筛查以及明确传达吸烟和使用烟草不健康这一信息的重要性。
