Tobacco Free Nurses

Tobacco Free Nurses

Background & Goal

Tobacco use is the leading cause of preventable death worldwide, contributing to significant suffering and disability. As the largest group of health care professionals, nurses have tremendous potential to effectively implement smoking cessation interventions and advance tobacco use reduction goals as proposed by Healthy People 2020. In 2003, Drs. Linda Sarna and Stella Aguinaga Bialous, Co-Principal Investigators, designed and implemented Tobacco Free Nurses (“TFN”) to support nurses in assisting patients with tobacco dependence treatment, translating evidence into practice, enhancing nurses’ involvement in tobacco control efforts nationally and internationally, and helping nurses and student nurses – who had a higher smoking rate than other health professionals – stop smoking.

Program Description

Working with nurse champions, nursing and health professional organizations, academic centers and other partners, TFN tested combinations of low-cost web-based interventions and print media to enhance nurses’ involvement in all aspects of tobacco control. TFN activities are housed on their award-winning website, Since 2003, TFN has designed and implemented national and international projects which 1) provide tobacco cessation education to practicing nurse clinicians, 2) provide tobacco control resources for patient care, 3) support and assist smoking cessation efforts of nurses and nursing students and 4) enhance the culture of nurses as leaders and advocates of a tobacco free society. To translate evidence from the US Public Health Services’ Tobacco Dependence Treatment Guideline into practice, TFN developed a pocket guide, Helping Smokers Quit- A Guide for Clinicians, which has been one of the most widely requested print documents from the Agency for Healthcare Research & Quality, republished in many formats and translated into multiple languages.

Evidence of Success

TFN has been recognized by the World Health Organization as an exemplar of health professional advocacy in tobacco control. As of February 2017, over 6,000 nurses have formally participated in TFN educational and policy efforts in the United States and in eight other countries. If each of these 6,000 nurses advised only one patient/week to quit x 12 months for 4 years, 1.3 million smokers would have received support to make a quit attempt. Tobacco use costs $300 billion a year in the United States. Currently, 36.5 million adults continue to smoke. A 10% reduction in smoking rates would lead to 3.65 million ex-smokers, and a large reduction in costs, morbidity and mortality. The 3 million nurses nationwide could easily help make this a reality. Since TFN was launched in 2003, there has been a 36% decline in the prevalence of smoking among registered nurses, to an all-time low of 7% in 2011, as reported in JAMA as part of the issue celebrating the 50th anniversary of the US Surgeon General Report.

More Information

Linda Sarna, PhD, RN, FAAN

Sarna_Linda_.jpgDean & Professor
Lulu Wolf Hassenplug Endowed Chair
UCLA School of Nursing
2-256 Factor
700 Tiverton Avenue
Los Angeles, CA 90095
Phone: 310-825-9621

Stella Aguinaga Bialous, DrPH, RN, FAAN

Bialous_Stella.jpgAssociate Professor in Residence
Social and Behavioral Sciences
UCSF School of Nursing
3333 California St., Suite 340
San Francisco, CA 94118
Phone: 415-502-3353