Purpose and scope
The purpose of this best practice guideline (BPG) is to provide nurses and the circle of care with evidence-based recommendations on culturally safe and meaningful ways to support smoking reduction and cessation with Indigenous Peoples of reproductive age, their support networks and communities to improve health and wellness.
The recommendations in this BPG may be directed to one or more of the aforementioned populations based on the evidence. This BPG recognizes that the context in which Indigenous Peoples of reproductive age (including adolescents, women and persons who are pregnant or in the prenatal phase and parents) live is in relationship to their support network and greater community.
This BPG emphasizes that Indigenous Peoples of reproductive age, their support network and communities are experts in their health and decision making. Collaboration among the circle of care, people, support networks and communities is therefore essential to achieving improved health outcomes. It is important to note that Indigenous Peoples of reproductive age and their support networks may have health and wellness needs that are more important to them to address, and this should be considered in the implementation of this BPG.
This BPG is to be used by nurses, members of the circle of care in:
- primary care
- community care
- and maternal/child settings
and in all domains of practice (e.g., administration, clinical, education, policy and research). It is also to be used by organizations that employ nurses and members of the circle of care, including health- and social-service organizations and academic settings.
The interventions for smoking reduction and cessation in this BPG are specific to commercial tobacco, which is distinct from traditional tobacco. Although the terminology “smoking” is used, the scope includes all forms of commercial tobacco products including but not limited to:
- cigarettes
- cigars
- cigarillos
- chewing tobacco
- dissolvables
- hookah/water pipe/shisha
- snuff
- roll-your-own cigarettes and
- pipes.
The interventions in this BPG focus on smoking reduction and cessation. Smoking cessation is the ultimate goal; however, it is important to recognize that for many people reducing the use of commercial tobacco may be a part of the journey to cessation.
Get started
Registered Nurses’ Association of Ontario. (2022). Promoting Smoking Reduction and Cessation with Indigenous Peoples of Reproductive Age and Their Communities. Toronto, ON: Registered Nurses' Association of Ontario.
Recommendations
Do you want to learn about and implement the most- up-to-date evidence-based recommendations on this topic with your colleagues? Download and share the full best practice guideline (BPG), Promoting Smoking Reduction and Cessation with Indigenous Peoples of Reproductive Age and Their Communities.
See below for a snapshot of the recommendations from this BPG. We strongly suggest you review the full BPG before implementing the recommendations and good practice statements. The BPG also includes further resources to support implementation and evaluation.
Good practice statement: As part of a wholistic health assessment, a member of the circle of care has a conversation about smoking, in a culturally safe way, with Indigenous person of reproductive age and their support network.
Recommendation 1: It is recommended that smoking reduction and cessation services be Indigenous-led and grounded in a wholistic approach to health and wellness. The circle of care provides culturally safe and tailored services with perinatal Indigenous women and persons and their support network.
Recommendation 2: It is recommended that the circle of care offer smoking reduction and cessation counselling with Indigenous women and persons during pregnancy and the post-partum period. It is important that counselling is provided in a culturally safe way and that it is part of an overall wholistic approach to health and wellness.
Recommendation 3: It is recommended that wholistic and culturally specific smoking reduction and cessation services also be offered to the support network of the perinatal Indigenous women and persons who are accessing these services.
Recommendation 4: It is suggested that, when needed, the circle of care offer nicotine replacement therapy, in addition to counselling, to Indigenous women and persons during pregnancy.
Recommendation 5: It is recommended that academic settings integrate compulsory Indigenous health and Indigenous cultural safety content into college and university educational curricula for all students entering health professions. *Call to Action #24, Truth and Reconciliation Commission, 2015
Recommendation 6: It is recommended that health and social service organizations integrate Indigenous health and cultural safety education within continuing professional development for all health providers. *Call to Action #23, Truth and Reconciliation Commission, 2015
Recommendation 7: It is recommended that the circle of care advocate for equitable access to smoking reduction and cessation services for Indigenous Peoples of reproductive age and their support network. This can include access to circles of support and nicotine replacement therapy (NRT).
Recommendation 8: It is recommended that health service organizations embed smoking reduction and cessation services within existing health and wellness programs.
Recommendation 9: It is recommended that Indigenous communities advance the health and wellness of all community members through the promotion of indoor and outdoor smoke free spaces.
Disclaimer: These guidelines are not binding for nurses, other health providers or the organizations that employ them. The use of these guidelines should be flexible and based on individual needs and local circumstances. They constitute neither a liability nor discharge from liability. While every effort has been made to ensure the accuracy of the contents at the time of publication, neither the authors nor the Registered Nurses’ Association of Ontario (RNAO) gives any guarantee as to the accuracy of the information contained in them or accepts any liability with respect to loss, damage, injury or expense arising from any such errors or omission in the contents of this work.
