1. Sarna, Linda DNSc, RN, AOCN, FAAN

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In September 2011, a "High-Level Meeting of the United Nations General Assembly" addressed the urgent need for greater measures to reduce the devastation from largely preventable noncommunicable diseases (NCDs; United Nations [UN], 2011; World Health Organization [WHO], 2011b). Four groups of diseases targeted in this initiative-cancer, heart disease, chronic respiratory disease, and diabetes-are associated with 63% of deaths worldwide, 80% in low- and middle-income countries (WHO, 2010). By acknowledging NCDs as both preventable and controllable, the political will of individual countries and a community of nations may provide a means to galvanize research efforts with expanded funding worldwide. Although the label of NCDs is new, nursing research in these areas is not. Nursing research addresses the wide range of complex issues affecting people at risk for and with these diseases. However, nursing research, which is focused on the four identified risk factors associated with NCDs as defined by the WHO (tobacco use, lack of physical activity, unhealthy diet, and harmful use of alcohol), is woefully inadequate (WHO, 2010).


Tobacco use is the one risk factor that cuts across all four disease categories. Statistics describing tobacco use are not new, but they have not received attention from nurse researchers commensurate with the resulting level of deaths and suffering. The statistics are staggering. Approximately 6 million people worldwide die prematurely from tobacco or exposure to secondhand smoke every year. Almost 100 million people died from tobacco use in the last century, and another 1 billion are predicted to die prematurely in the 21st century if things do not change (WHO, 2011a). These shocking statistics are only a partial indicator of the devastating impact of tobacco on the suffering and misery among people of all ages and on the very fabric of society, not to mention the profound economic and environmental consequences. Ironically, data from nurse smokers who participated in the Nurses' Health Study in the mid-1970s contributed to our understanding of tobacco as a risk factor (Sarna et al., 2008). Unclear from the primarily male data in the 1964 Surgeon General Report (U.S. Department of Health, Education, and Welfare, 1964), data from the Nurses' Health Study revealed that smoking kills women too (Kenfield et al., 2010).


Tobacco control is a robust area for scholarly inquiry, but the presence of nurse scientists in this field is still relatively limited. The emphasis on NCDs may link the compelling need for research with a demand for clinical expertise and evidence-based practice. Will labeling tobacco as a risk factor for NCDs motivate more nurse researchers to focus on creative and innovative proposals to prevent tobacco use, to treat nicotine dependence, and to explore strategies to minimize secondhand smoke? I hope so. The effects of the UN meeting will be observed closely as individual countries review their priorities, set their agendas, and allocate resources (UN, 2011). I expect there to be calls to action and funding opportunities for research addressing both NCDs and risk factors. I hope that nurse researchers will be ready to seize this opportunity.


Linda Sarna, DNSc, RN, AOCN, FAAN


University of California, Los Angeles




Kenfield S. A., Wei E. K., Rosner B. A., Glynn R. J., Stampfer M. J., Colditz G. A. (2010). Burden of smoking on cause-specific mortality: application to the Nurses' Health Study. Tobacco Control, 19, 248-254. [Context Link]


Sarna L., Bialous S. A, Jun H. J., Wewers M. E., Cooley M. E., Feskanich D. (2008). Smoking trends in the Nurses' Health Study (1976-2003). Nursing Research, 57, 374-382. [Context Link]


United Nations. (2011). Political declaration of the high-level meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. Retrieved October 24, 2011, from[Context Link]


U.S. Department of Health, Education, and Welfare (USDHEW). (1964). Smoking and health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. Washington, DC: U.S. Department of Health, Education, and Welfare, Public Health Service. No. 1103. [Context Link]


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World Health Organization. (2011b). United Nations high-level meeting on noncommunicable disease prevention and control. Geneva, Switzerland: World Health Organization. Retrieved October 22, 2011, from[Context Link]