Increasing smoking cessation counseling by advanced practice nurses.

The magnitude of individual and societal problems caused by tobacco use mandates that all primary care providers identify and advise smokers to quit. However, this topic has received little attention in the nurse practitioner literature. The purpose of this project is to identify effective methods by which advanced practice nurses can increase the identification and counseling of smokers by reviewing research on this topic. The articles for review were obtained through a computerized literature search and a review of related reference lists. The articles were analyzed and categorized into three groups: office-wide interventions to increase provider identification and counseling of smokers, smoking cessation training programs for providers, and studies using the stages of change theory. Provider smoking cessation programs and office-wide reminders increased the identification and counseling of patients who smoke. The stages of change theory helped explain the steps smokers must progress through to cease smoking. Interventions appropriate for various stages in the cessation process are suggested.