ISNCC Tobacco Position Statement.

Background Tobacco use and exposure to tobacco smoke are known human carcinogens and have contributed to a global epidemic and public health emergency. Tobacco continues to be a leading cause of preventable death and illness in the world. At least one dozen different types of cancers are causally related to tobacco use, in addition to other chronic and acute illnesses. Six million tobacco-related deaths occur every year. If trends continue, by 2030 more than 8 million people will die annually because of tobacco use; 80% in developing countries. Prevention of tobacco-related disease, disability, and death could be achieved through the promoting of tobacco control: preventing uptake, helping smokers quit, and preventing exposure to secondhand smoke. Nurses can effectively deliver evidence-based interventions for tobacco dependence that significantly reduce tobacco use, including to patients already diagnosed with cancer. Quitting smoking after a cancer diagnosis improves prognosis and treatment outcomes and decreases risk of a secondary cancer and death. At least one dozen different types of cancers are causally related to tobacco use. Nursing involvement in community action, helping patients quit, promoting an environment free of tobacco smoke, denormalising tobacco use and supporting effective tobacco control policies is essential to solve this problem. Nurses must provide leadership in these efforts, along with other healthcare professionals. To address the tobacco-related epidemic, WHO initiated the first international, legally binding treaty focusing on a public health problem: the WHO Framework Convention on Tobacco Control (FCTC). The treaty calls for implementation of a series of policy measures with proven effectiveness in reducing the burden of tobacco use on the population and nations. Nurses worldwide have been involved in efforts to ensure that these policies are adopted, but further efforts are needed. Patients who smoke often are blamed unfairly or blame themselves for causing a tobacco-related cancer. In fact, many became addicted to nicotine in their adolescence or youth by an industry that spends billions of dollars to promote a product that, if used as directed, kills up to 50% of its users. Nurses must actively engage in efforts to diminish this stigma. Tobacco dependence is a chronic relapsing condition that requires ongoing treatment. The tobacco industry has been found guilty of hiding evidence from the public and obfuscating science and scientists, and calls have been made for professional organizations and academic centers to refuse to accept tobacco industry funding for research or services. The past decade has seen an increase in the marketing and availability of electronic nicotine delivery devices (ENDS), also known as electronic cigarettes, electronic hookahs, etc., particularly in Upper Income Countries. Regulatory frameworks to address these new products are emerging, and there are no data available to support these products_ safety or their effectiveness as adjuncts in tobacco dependence treatment. WHO has advised consumers to not use these products until data are available. Nursing research in the area of tobacco control and tobacco dependence treatment can contribute significantly to developing interventions for all persons who smoke, including people with a cancer diagnosis, but more efforts and support are needed to enhance the science in this area. Many health care organisations have identified position statements or endorsed position statements in relation to tobacco, smoking, and health. These organisations include: The World Health Organisation, Oncology Nursing Society (USA), Royal College of Nursing (United Kingdom) and International Council of Nurses. All these statements advocate control of tobacco use and endorsing anti-smoking policies.