Laura Bond

Date of Award


Document Type

Thesis - ECU Access Only


Edith Cowan University

Degree Name

Master of Public Health


Faculty of Computing, Health and Science

First Supervisor

Donna Cross

Second Supervisor

Robyn Johnston

Third Supervisor

Colleen Fisher


Most people who smoke cigarettes commenced smoking during adolescence. School nurses are well placed within the secondary school setting to provide support to students for school tobacco control and smoking cessation services.

The overall aim of this research was to determine the capacity and effectiveness of Western Australian secondary school nurses to help adolescents who smoke tobacco to quit, or reduce use to minimise harm from smoking. The project also aimed to provide further recommendations for supporting school nurses in Western Australia to help adolescents who smoke tobacco to quit or reduce use to minimise harm from smoking.

A mixed method approach was applied and comprised a comprehensive review of literature, semi‐structured interviews with school nurses, administrative staff and health and physical education staff, and a quantitative survey comprising open‐ended questions of secondary school students from Years 8 to 10. School nurses were interviewed to determine their involvement with, skills and training in, and barriers to providing smoking cessation and other harm reduction advice/support to students. Administrative and health and physical education staff were interviewed to better understand school policies, environment and support networks available to help students quit or reduce smoking. Student surveys were used to gather information about student thoughts and beliefs about smoking and smoking cessation, and their receptivity to school nurses giving them support to quit smoking.

The development and validation of research methodology and instruments was supported by an expert panel. The data were analysed independently using qualitative and quantitative methods. Qualitative data were coded according to themes under research and interview questions using the NVivo qualitative data analysis package. Quantitative data were analysed using the SPSS statistical analysis package and included descriptive statistics, cross‐tabulations and Chi‐square tests. A triangulation of the data was used to combine and discuss the findings.

This study found that most of the school nurses who participated in the research delivered tobacco control and/or smoking cessation support to students. School‐level factors influenced the extent of involvement of school nurses in tobacco control and cessation programs and services. Barriers to involvement included lack of time and resources, limited access to students, minimal or no prior training in tobacco control or cessation support, limited support from the school and low levels of communication and collaboration with other staff, parents and community members. Student support for school‐based programs and services for tobacco control and cessation was strong. Students identified counselling by a school psychologist, chaplain or nurse, provision of health education and punishment for smoking at school as important school‐based supports for students who smoke. Students recommended that nurses be more approachable, aim to build rapport with students, promote available services, and ensure confidentially to increase student participation in programs and services. The results of this study have informed a number of recommendations for school policy, school support and involvement of the school nurse in tobacco control and smoking cessation. These findings were used to guide the development of a larger capacity building project Optimising School Nurse Involvement in Youth Based Tobacco Control Programs.

LCSH Subject Headings

School nursing -- Western Australia.

Children -- Tobacco use -- Western Australia -- Prevention.

Health education (Primary) -- Western Australia.