Smoking cigarettes is killing America! Tobacco use is the most preventable cause of premature death and disability in the United States. Tobacco kills more than 400,000 Americans per year by causing coronary heart disease, lung and other cancers, chronic obstructive lung disease including emphysema and bronchitis, acute respiratory infections and cerebral vascular accidents. (1) Despite these facts, 25% of adults in the United States — 28 million men and 23 million women — continue to smoke. Smoking is most prevalent in the age group of 25 - 44 year olds. There are alarming statistics revealing that approximately 90% of new smokers are teenagers. More than 3,000 adolescents under the age of 18 are starting to smoke every day! (2) Cigarette use is increasing on college campuses nationwide. (3) Other groups with higher rates of smoking include:

• people who have an educational level of high school or lower
• manual laborers
• military personnel
• certain minorities including African-Americans, Hispanics, Native Americans and Southeast Asians. (4)

Given these disheartening numbers, how can a staff nurse motivate patients to quit smoking and help to change these statistics? This continuing education article outlines the essentials of counseling for smoking cessation, whether it's in the inpatient acute care setting, the outpatient clinic, home care or the ICU!