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Abou-ElWafa HS, Zoromba MA, El-Gilany AH. Cigarette smoking at workplace among resident physicians and nurses in Mansoura University Hospital. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:37-44. [PMID: 32469291 DOI: 10.1080/19338244.2020.1771249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Smoking at workplace (WP) is common among healthcare workers. A cross-sectional study was conducted upon resident physicians and nurses to determine the prevalence of WP smoking and its associated factors. A questionnaire was used to collect socio-demographic and occupational data, smoking history, nicotine dependence, and attitude toward smoking and its control in WP. More than one-fifths (22.7%) of residents and nurses were current WP smokers. Significant independent predictors are having shift work, high nicotine dependence, and having positive attitude toward smoking with AOR (95% CI): 29.4 (4.9-177.1), 18.2 (3.3-101.1), and 0.16 (0.02-0.84), respectively. The prevalence of smoking among resident physicians and nurses in Mansoura University Hospital is relatively high. Enforcement of WP smoking-free policies is required together with encouragement of positive attitude toward smoking cessation.
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Affiliation(s)
- Hala Samir Abou-ElWafa
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Ali Zoromba
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Abdel-Hady El-Gilany
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Nilan K, McKeever TM, McNeill A, Raw M, Murray RL. Prevalence of tobacco use in healthcare workers: A systematic review and meta-analysis. PLoS One 2019; 14:e0220168. [PMID: 31344083 PMCID: PMC6657871 DOI: 10.1371/journal.pone.0220168] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/10/2019] [Indexed: 12/25/2022] Open
Abstract
Objectives To estimate tobacco use prevalence in healthcare workers (HCW) by country income level, occupation and sex, and compare the estimates with the prevalence in the general population. Methods We systematically searched five databases; Medline, EMBASE, CINHAL Plus, CAB Abstracts, and LILACS for original studies published between 2000 and March 2016 without language restriction. All primary studies that reported tobacco use in any category of HCW were included. Study extraction and quality assessment were conducted independently by three reviewers, using a standardised data extraction and quality appraisal form. We performed random effect meta-analyses to obtain prevalence estimates by World Bank (WB) country income level, sex, and occupation. Data on prevalence of tobacco use in the general population were obtained from the World Health Organisation (WHO) Global Health Observatory website. The review protocol registration number on PROSPERO is CRD42016041231. Results 229 studies met our inclusion criteria, representing 457,415 HCW and 63 countries: 29 high-income countries (HIC), 21 upper-middle-income countries (UMIC), and 13 lower-middle-and-low-income countries (LMLIC). The overall pooled prevalence of tobacco use in HCW was 21%, 31% in males and 17% in females. Highest estimates were in male doctors in UMIC and LMLIC, 35% and 45%, and female nurses in HIC and UMIC, 21% and 25%. Heterogeneity was high (I2 > 90%). Country level comparison suggest that in HIC male HCW tend to have lower prevalence compared with males in the general population while in females the estimates were similar. Male and female HCW in UMIC and LMLIC tend to have similar or higher prevalence rates relative to their counterparts in the general population. Conclusions HCW continue to use tobacco at high rates. Tackling HCW tobacco use requires urgent action as they are at the front line for tackling tobacco use in their patients.
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Affiliation(s)
- Kapka Nilan
- UK Centre for Tobacco and Alcohol Studies, School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, United Kingdom
- * E-mail: (KN); (RLM)
| | - Tricia M. McKeever
- UK Centre for Tobacco and Alcohol Studies, School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, United Kingdom
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Martin Raw
- NYU College of Global Public Health, New York University, New York, New York, United States of America
- NYU Medical School, New York University, New York, New York, United States of America
| | - Rachael L. Murray
- UK Centre for Tobacco and Alcohol Studies, School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, United Kingdom
- * E-mail: (KN); (RLM)
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Santos MDDV, Santos SV, Caccia-Bava MDCGG. [The prevalence of strategies for cessation of tobacco use in primary health care: an integrative review]. CIENCIA & SAUDE COLETIVA 2019; 24:563-572. [PMID: 30726388 DOI: 10.1590/1413-81232018242.27712016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/23/2017] [Indexed: 11/22/2022] Open
Abstract
The habit of tobacco use/smoking, which is a major concern of Primary Health Care (PHC), is a serious public health problem and the main avoidable cause of death in the world. The relevance of actions, whose focus is to facilitate the cessation of this habit, motivates the discussion of studies that have different approaches to tackle this issue by seeking to train PHC professionals accordingly. A search was conducted in the Lilacs, MEDLINE and Web of Science databases for recent scientific publications (2010-2015). The key words were combined with Boolean operators and, after analysis of the articles found, 75 are discussed in this article since they have strategies with a higher prevalence in PHC. The conclusion drawn is that the brief or intense individual approach using the 5A method (Transtheoretical Model) is the most widely adopted, as well as bupropion and nicotine replacement patches. The increasing use of hard technology requires new studies that examine their impact on the treatment of smokers. It was clearly revealed that there is a need for health professionals to be better prepared to address the issue with the users, in addition to a lack of stimulus and proper conditions to work in the PHC team directly reflecting scientific advances in clinical practice.
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Affiliation(s)
- Meire de Deus Vieira Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900, Monte Alegre. 14048-900 Ribeirão Preto SP Brasil.
| | - Stella Vieira Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900, Monte Alegre. 14048-900 Ribeirão Preto SP Brasil.
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Northrup TF, Stotts AL, Suchting R, Khan AM, Green C, Quintana PJE, Hoh E, Hovell MF, Matt GE. Medical staff contributions to thirdhand smoke contamination in a neonatal intensive care unit. Tob Induc Dis 2019; 17:37. [PMID: 31516480 PMCID: PMC6662774 DOI: 10.18332/tid/106116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Non-smoking policies are strictly enforced in neonatal intensive care units (NICUs), which may still become contaminated by thirdhand smoke (THS), posing potential health risks to medically fragile infants. Study aims were to explore contamination routes by characterizing nicotine levels (THS proxy) found on the fingers of NICU medical staff and to assess finger-nicotine correlates. METHODS NICU medical staff were surveyed regarding smoking and electronic nicotine devices (ENDS) use/exposure, and household characteristics. Approximately 35% of staff were randomly selected for a finger-nicotine wipe. Three separate quantile regressions modeled percentiles associated with: presence of any finger nicotine, finger-nicotine levels above the median field blank level (i.e. 0.377 ng/wipe), and finger-nicotine levels two times the median blank. RESULTS The final sample size was 246 (n=260 approached; n=14 refusals). Over three-quarters (78.5%) reported some exposure to tobacco smoke or ENDS vapor/aerosols. After field-blank adjustments, the median nicotine level (ng/finger wipe) was 0.232 (IQR: 0.021–0.681) and 78.3% of medical staff had measurable finger-nicotine levels. Both being near smoking in friends’/family members’ homes and finger-surface area were related to elevated finger-nicotine levels (p<0.05) in the median blank model. CONCLUSIONS Almost four in five NICU staff had measurable finger nicotine, with finger surface area and frequency of reported exposure to tobacco smoke in friends’/family members’ homes emerging as important correlates. Future research will determine the impact of THS on NICU infants. Medical personnel working in a NICU should be cognizant of secondhand smoke and THS, particularly inside friends’/family members’ homes, to reduce potential NICU contamination and infant exposures.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Angela L Stotts
- Department of Family and Community Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States.,Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Amir M Khan
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Charles Green
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States.,Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Penelope J E Quintana
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, United States
| | - Eunha Hoh
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, United States
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, School of Public Health, San Diego State University, San Diego, United States
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, United States
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Martínez C, Baena A, Castellano Y, Fu M, Margalef M, Tigova O, Feliu A, Laroussy K, Galimany J, Puig M, Bueno A, López A, Fernández E. Prevalence and determinants of tobacco, e-cigarettes, and cannabis use among nursing students: A multicenter cross-sectional study. NURSE EDUCATION TODAY 2019; 74:61-68. [PMID: 30583124 DOI: 10.1016/j.nedt.2018.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/03/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Nurses are important agents in public health, which includes being active in tobacco control. Studies show that nurses who smoke are less inclined to offer smoking cessation aid. Nursing students, as the future labor force of nursing, are one of the key groups to monitor. OBJECTIVES To identify the prevalence and determinants of use of several tobacco products, e-cigarettes, and cannabis among nursing students in Catalonia. DESIGN Cross-sectional multicenter study. SETTINGS 15 university nursing schools in Catalonia (Spain) in 2015-2016. PARTICIPANTS Nursing students attending class at the day of the survey. METHODS An anonymous, self-administered questionnaire based on the Global Health Professional Survey was designed. The questions included information on consumption of several tobacco products (manufactured cigarettes, roll your own cigarettes, etc.), e-cigarettes, and cannabis. We estimated the prevalence of use (%) and computed multilevel logistic regressions models, at two levels, to calculate the odds ratios (OR) and their corresponding 95% confidence intervals (CI), adjusting for several individual sociodemographic variables and the nursing school as a grouping variable. RESULTS 4381 students participated in the study (57.2% of Nursing students in Catalonia at the time of the survey). 29.7% (95%CI: 27.2-32.2) were smokers (18.4% daily and 11.3% occasionally). 66.4% smoked manufactured cigarettes, 47.0% roll your own cigarettes, 10.0% waterpipe, and 0.4% e-cigarettes. The main predictors of smoking were: being ≥25 years (OR = 2.57, 95%CI: 2.03-3.26) and belonging to other Spanish regions (OR = 1.82, 95%CI: 1.30-2.54). 71.5% had low nicotine dependence as defined by the Heavy Smoking Index. Among 11.5% (95%CI: 10.6-12.4) of students used cannabis (daily or occasionally), and men presented higher odds of use (OR = 2.81, 95%CI: 2.11-3.73) than women. CONCLUSIONS Tobacco and cannabis use is high among nursing students. It is necessary to carry out early tobacco and cannabis cessation programs among young nursing students.
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Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain.
| | - Antoni Baena
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Health Sciences Studies Department, Universitat Oberta de Catalunya, Rambla de Poblenou, 156, 08018, Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Mercè Margalef
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olena Tigova
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Kenza Laroussy
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Jordi Galimany
- Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Montse Puig
- Nursing School of the Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Albert Bueno
- Nursing Care Management, EAP Roses, Institut Català de Salut, Crta Mas Oliva no 23, 17480 Roses, Alt Empordà, Spain
| | - Antonio López
- Nursing Care Management, EAP Valls urbano, c/ Vallvera no 8, Valls, CP: 43800, Tarragona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Medicine and Health Sciences Faculty, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
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Rezk-Hanna M, Sarna L, Petersen AB, Wells M, Nohavova I, Bialous S. Attitudes, barriers and facilitators to smoking cessation among Central and Eastern European nurses: A focus group study. Eur J Oncol Nurs 2018; 35:39-46. [PMID: 30057082 DOI: 10.1016/j.ejon.2018.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/16/2018] [Accepted: 04/06/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Smoking among nurses is a barrier to providing smoking cessation interventions to patients. In Central and Eastern Europe-where tobacco use is the leading cause of preventable death and disease-there is limited knowledge about nurses' attitudes toward cessation interventions. Our aim was to describe the attitudes of nurses who are former and current smokers toward providing cessation interventions to patients as well as explore barriers and facilitators to their own quit efforts. METHODS Nine focus groups with 81 nurses (94% females) in five Central and Eastern European countries. Content analysis was used to identify major themes. RESULTS Nurses agreed that they should set a good example by not smoking; should be involved in helping patients stop smoking; and needed additional training in tobacco control. Five common themes were identified as barriers to quitting: smoking cues in the environment; presence of smokers in the environment; relapse postpartum; stress and nicotine addiction; and misperceptions about the dangers of smoking. Former smokers reported facilitators to quitting including: seeing the health consequences of smoking among their patients; personal and family health concerns; receiving support from family; and pregnancy. CONCLUSION There is a need to build upon nurses' positive attitudes about engaging in smoking cessation interventions with patients to ensure that cessation interventions are standard nursing practice. Future studies should focus on programs that support nurses' quit efforts by addressing barriers to smoking cessation, which will improve their health and patient care.
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Affiliation(s)
- Mary Rezk-Hanna
- School of Nursing, University of California, Los Angeles, CA, USA
| | - Linda Sarna
- School of Nursing, University of California, Los Angeles, CA, USA
| | - Anne Berit Petersen
- School of Nursing, Loma Linda University, Loma Linda, CA, USA; Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
| | - Marjorie Wells
- School of Nursing, University of California, Los Angeles, CA, USA
| | - Iveta Nohavova
- Society for Treatment of Tobacco Dependence, Prague, Czech Republic
| | - Stella Bialous
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA; Department of Social Behavioral Sciences, School of Nursing, University of California, San Francisco, CA, USA.
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Juranić B, Rakošec Ž, Jakab J, Mikšić Š, Vuletić S, Ivandić M, Blažević I. Prevalence, habits and personal attitudes towards smoking among health care professionals. J Occup Med Toxicol 2017; 12:20. [PMID: 28769993 PMCID: PMC5530462 DOI: 10.1186/s12995-017-0166-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 07/19/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Tobacco use is the second major cause of morbidity and the 4th most common health risk factor in the world. Medical professionals have a critical role in the process of smoking cessation both as advisers and behavioural models for the citizens. The aim of this study was to investigate the prevalence of smoking among health care professionals, their smoking habits and personal attitudes toward smoking, role and the responsibility of health care professionals in the prevention of smoking. RESULTS Out of the total number of examinees, 175 (35,1%) are active smokers, 29 (5,8%) are former smokers, and 295 (59,1%) are non-smokers. Nurses with secondary education disagree the most with the claim that passive smoking is more harmful to health (χ2 test, p = .008), also with the claim that the introduced Smoking Act is fair to smokers (χ2 test, p = .021). More nurses with secondary education disagree completely or partially that one should pay attention to smoking in the presence of non-smokers (χ2 test, p = .012). CONCLUSION Training programs for health care workers are needed to improve their ability in smoking cessation techniques to provide active support to their patients.
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Affiliation(s)
- Brankica Juranić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 10/E, HR-31000 Osijek, Croatia
| | - Željko Rakošec
- Department of Culturology, Josip Juraj Strossmayer University of Osijek, Trg Svetog Trojstva 3, Osijek, Croatia
| | - Jelena Jakab
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 10/E, HR-31000 Osijek, Croatia
| | - Štefica Mikšić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 10/E, HR-31000 Osijek, Croatia
| | - Suzana Vuletić
- Catholic Faculty of Theology in Đakovo, Josip Juraj Strossmayer University of Osijek, Petra Preradovića 17, Đakovo, Croatia
| | - Marul Ivandić
- Public Health Centre Osijek, Park kralja Petra Krešimira IV. 6, HR-31000 Osijek, Croatia
| | - Ivka Blažević
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 10/E, HR-31000 Osijek, Croatia
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Geiser F, Much M, Beyer K. Self-evaluation of tobacco exposure by allied health students in a community college setting. SAGE Open Med 2017; 5:2050312117699503. [PMID: 28491303 PMCID: PMC5406194 DOI: 10.1177/2050312117699503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 02/14/2017] [Indexed: 11/15/2022] Open
Abstract
Objective: Tobacco education is among the initiatives encouraged for health professionals to help them appreciate the significance of addressing tobacco use among their patients. In this pilot study, a nicotine biomarker (cotinine) study was introduced to an applied microbiology course required of all allied health students. Participants assessed their own smoking status in the previous 24 h using a two-dimensional experimental design of a questionnaire and rapid urinary cotinine immunoassay. The study goals were >90% participation of the home-administered assay and high correlation of the results to cotinine standards. Allied health students (medical assistants, respiratory therapists, surgical technicians) were selected as the initial test group. Methods: The study was initiated 10 months after the college became 100% tobacco free. Participants were initially trained on the use and interpretation of the rapid cotinine test using three cotinine standards (0, 400, and 2000 ng/mL urine). Participants subsequently tested their own first-morning urine sample at home and then answered a questionnaire about their tobacco smoke (and/or nicotine) exposure in the previous 24-h period. Results: The cotinine laboratory was offered to a total of 161 students (88% female) over 24 months. Participants who reported no exposure to a nicotine product in any venue made up 55% of the group. Daily smokers made up 17% of the study participants as confirmed by their elevated cotinine levels (greater than 100 ng/mL urine). The remaining participants (28%) either resided with smokers and/or rode in an automobile with an individual smoking in the previous 24 h. Their cotinine levels were moderately elevated in some cases, particularly if they had ridden in a car with a smoker. Conclusion: The pilot study met our objectives of >90% participation and high correlation of urinary cotinine levels with questionnaire self-reports.
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Affiliation(s)
- Fiona Geiser
- Allied Health, Emergency Services and Nursing Department, Delaware County Community College, Media, PA, USA
| | - Meredith Much
- Allied Health, Emergency Services and Nursing Department, Delaware County Community College, Media, PA, USA
| | - Karen Beyer
- Allied Health, Emergency Services and Nursing Department, Delaware County Community College, Media, PA, USA
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Petersen AB, Meyer B, Sachs BL, Bialous SA, Cataldo JK. Preparing nurses to intervene in the tobacco epidemic: Developing a model for faculty development and curriculum redesign. Nurse Educ Pract 2017; 25:29-35. [PMID: 28463761 DOI: 10.1016/j.nepr.2017.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/11/2016] [Accepted: 04/07/2017] [Indexed: 10/19/2022]
Abstract
As the largest group of health professionals, nurses have a tremendous potential to help curb the tobacco epidemic. However, studies conducted across a range of global settings continue to indicate that both practicing nurses and nursing student have limited knowledge, skills and confidence needed to implement evidence-based tobacco cessation interventions. A contributing factor is the limited inclusion of tobacco control content in nursing curricula. Additionally, there is limited understanding of nurse educators' knowledge and perceptions about teaching tobacco dependence content. This paper presents the Loma Linda University School of Nursing's concurrent experience with both faculty development and curriculum redesign in the area of tobacco dependence prevention and treatment. An internal survey was administered at baseline and at 2-year follow-up to assess faculty's knowledge, perceptions and practices related to teaching tobacco dependence content and skills (n = 42). Faculty and curriculum development strategies and resources utilized, evaluation findings and subsequent lessons learned are described. The findings have implications for nursing programs seeking to enhance their curricula and commitment to ensuring that their graduates are prepared to provide evidence-based tobacco cessation interventions with each patient they encounter.
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Affiliation(s)
- Anne Berit Petersen
- Loma Linda University, School of Nursing, 11262 Campus St., West Hall, Loma Linda, CA 92350, USA; Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA.
| | - Bonnie Meyer
- Loma Linda University, School of Nursing, 11262 Campus St., West Hall, Loma Linda, CA 92350, USA.
| | - Bonnie L Sachs
- Palo Alto Center for Pulmonary Disease Prevention, 145 North California Avenue, Palo Alto, CA 94301-3911, USA.
| | - Stella A Bialous
- Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA; University of California, San Francisco, School of Nursing, 2 Koret Way, San Francisco, CA 94143, USA.
| | - Janine K Cataldo
- Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA; University of California, San Francisco, School of Nursing, 2 Koret Way, San Francisco, CA 94143, USA.
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Nicholls R, Perry L, Gallagher R, Duffield C, Sibbritt D, Xu X. The personal cancer screening behaviours of nurses and midwives. J Adv Nurs 2017; 73:1403-1420. [DOI: 10.1111/jan.13221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Rachel Nicholls
- Faculty of Health University of Technology Sydney New South Wales Australia
| | - Lin Perry
- Faculty of Health University of Technology Sydney New South Wales Australia
| | - Robyn Gallagher
- Charles Perkins Centre Sydney Nursing School University of Sydney New South Wales Australia
| | - Christine Duffield
- Centre for Health Services Management Faculty of Health University of Technology Sydney New South Wales Australia
- Edith Cowan University Perth Western Australia Australia
| | - David Sibbritt
- Faculty of Health University of Technology Sydney New South Wales Australia
| | - Xiaoyue Xu
- Faculty of Health and Medicine University of Newcastle New South Wales Australia
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11
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Cigarette Smoking Prevalence Among Adults Working in the Health Care and Social Assistance Sector, 2008 to 2012. J Occup Environ Med 2016; 57:1107-12. [PMID: 26461866 DOI: 10.1097/jom.0000000000000529] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The primary objective of this study was to estimate current smoking among workers in the health care and social assistance sector. METHODS We analyzed the 2008 to 2012 National Health Interview Survey data for adults (age 18 years or more) working in health care and social assistance sector who reported current cigarette smoking. RESULTS Of the approximately 18.9 million health care and social assistance workers, 16.0% were current cigarette smokers. Smoking prevalence was highest in women (16.9%) and among workers: age 25 to 44 years (17.7%); with a high school education or less (24.4%); with income less than $35,000 (19.5%); with no health insurance (28.5%); in the nursing and residential care facilities (26.9%) industry; and in the material recording, scheduling, dispatching, and distributing (34.7%) occupations. CONCLUSIONS These findings suggest that specific group of workers in the health care and social assistance sector might particularly benefit from cessation programs and incentives to quit smoking.
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Gallus S, Lugo A, Garattini S, Pacifici R, Mastrobattista L, Marzo G, Paglia L. General Practitioners and Dentists: A Call for Action Against Tobacco. Nicotine Tob Res 2016; 18:2202-2208. [PMID: 27613892 DOI: 10.1093/ntr/ntw162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/16/2016] [Indexed: 12/14/2022]
Abstract
INTRODUCTION To investigate the frequency of advice to quit smoking received by the Italian population from general practitioners (GP) and dentists, we analyzed a cross-sectional study. METHODS A face-to-face survey was conducted in 2014 on 3052 individuals, representative of the general Italian population aged 15 years or more. RESULTS During the previous year, 89% of individuals (82% of smokers) reported that they had visited a GP while 71% (67% of smokers) had visited a dentist. Among smokers, 25% reported that they had received advice to quit smoking from their GP, and 26% from their dentist. Advice by GPs was less frequently received by smokers with higher education (multivariate odds ratios (OR) were 0.48 for intermediate and 0.38 for high as compared to low education), and more frequently by heavy smokers (≥15 cigarettes/day; OR = 1.78), those with intention to quit (OR = 2.59), with previous quit attempts (OR = 2.09), and those aware of the existence of smoking cessation services (OR = 1.59). Advice by dentists was more frequently received by smokers aged 25-44 years (OR = 3.55 compared to those aged 15-24) and those with an intention to quit (OR = 2.46). Among Italian current smokers, 32% reported that their GP and 17% that their dentist was a current smoker. The corresponding figures among young smokers were 40% and 26%, respectively. CONCLUSION Healthcare providers have the potential to become a key reference point in the fight against smoking. However, before acting, GPs and dentists should set a good example: those who smoke should urgently quit or at least refrain from smoking during working hours. IMPLICATIONS GPs and dentists, reaching the large majority of Italian smokers, can make a major contribution in the fight against tobacco. Future studies are needed to investigate possible reasons of the apparently high smoking prevalence among GPs, in order to develop tailored smoking cessation interventions for healthcare providers.
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Affiliation(s)
- Silvano Gallus
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy;
| | - Alessandra Lugo
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Silvio Garattini
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Roberta Pacifici
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Luisa Mastrobattista
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Giuseppe Marzo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luigi Paglia
- Department of Maternal and Child Dentistry, Istituto Stomatologico Italiano, Milan, Italy.,Fondazione dell'Istituto Stomatologico Italiano (ISI), Milan, Italy
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Budhrani-Shani P, Berry DL, Arcari P, Langevin H, Wayne PM. Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review. Nurs Res Pract 2016; 2016:9018036. [PMID: 27446610 PMCID: PMC4947504 DOI: 10.1155/2016/9018036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 06/05/2016] [Indexed: 11/29/2022] Open
Abstract
Background. Chronic low back pain (CLBP) among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi) for CLBP among the general and nursing population, and describes implications. Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms: nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain, and/or risk factors. Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP. Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation.
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Affiliation(s)
- Pinky Budhrani-Shani
- Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX 77030, USA
- Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber/Harvard Cancer Center, Boston, MA 02215, USA
| | - Donna L. Berry
- Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber/Harvard Cancer Center, Boston, MA 02215, USA
| | | | - Helene Langevin
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Peter M. Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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14
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Hospital doctors' smoking behavior and attitude towards smoking cessation interventions for patients: a survey in an Italian Comprehensive Cancer Centre. TUMORI JOURNAL 2016; 2016:244-51. [PMID: 27079902 DOI: 10.5301/tj.5000501] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE Tobacco control guidelines recommend all healthcare professionals to ask patients about their smoking status and to offer them at least minimal cessation advice. However, few data are available about the daily practice of hospital clinicians who work with smoking cancer patients. This study assesses, in a comprehensive cancer center, the physicians' smoking habit, their clinical practice in offering a smoking cessation intervention to patients who smoke, and the training they received in this field. METHODS A Web-based survey was sent to 285 physicians. RESULTS The survey response rate was 75%. Sixty-two percent, 24%, and 14% of responders were never, former, and current smokers, respectively. Six percent of all responding physicians have already participated in smoking cessation training and 43% of them declared their willingness to be trained. Eighty-six percent of all responding physicians asked about the patients' smoking status, 50% routinely advised patients to quit smoking, and 32% assessed their motivation to do so. Smoking cessation guidelines were not followed mostly for lack of time, fear to increase patients' stress, and lack of smoking cessation training. Ninety-four percent of responding physicians knew the smoking cessation service for outpatients and 65% referred at least one patient, 66% of responding physicians knew the service for inpatients, and 36% of them asked for at least one intervention in the ward. CONCLUSIONS This study pointed out partial adherence of the physicians working in a leading cancer center to the smoking cessation guidelines. The clinicians' smoking habits did not influence the training and the clinical practice in offering patients smoking cessation interventions.
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Northrup TF, Khan AM, Jacob P, Benowitz NL, Hoh E, Hovell MF, Matt GE, Stotts AL. Thirdhand smoke contamination in hospital settings: assessing exposure risk for vulnerable paediatric patients. Tob Control 2015; 25:619-623. [PMID: 26635031 DOI: 10.1136/tobaccocontrol-2015-052506] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/07/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Tobacco has regained the status of the world's number two killer behind heart/vascular disease. Thirdhand smoke (THS) residue and particles from secondhand smoke (SHS) are suspected health hazards (eg, DNA damage) that are likely to contribute to morbidity and mortality, especially in vulnerable children. THS is easily transported and deposited indoors, where it persists and exposes individuals for months, creating potential health consequences in seemingly nicotine-free environments, particularly for vulnerable patients. We collected THS data to estimate infant exposure in the neonatal ICU (NICU) after visits from household smokers. Infant exposure to nicotine, potentially from THS, was assessed via assays of infant urine. METHODS Participants were mothers who smoked and had an infant in the NICU (N=5). Participants provided surface nicotine samples from their fingers, infants' crib/incubator and hospital-provided furniture. Infant urine was analysed for cotinine, cotinine's major metabolite: trans-3'-hydroxycotinine (3HC) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a metabolite of the nicotine-derived and tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). RESULTS Incubators/cribs and other furniture had detectable surface nicotine. Detectable levels of cotinine, 3HC and NNAL were found in the infants' urine. DISCUSSION THS appears to be ubiquitous, even in closely guarded healthcare settings. Future research will address potential health consequences and THS-reduction policies. Ultimately, hospital policies and interventions to reduce THS transport and exposure may prove necessary, especially for immunocompromised children.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth) Medical School, Houston, Texas, USA
| | - Amir M Khan
- Department of Pediatrics, UTHealth Medical School; Medical Director Level III NICU, Children's Memorial Hermann Hospital, Houston, Texas, USA
| | - Peyton Jacob
- Departments of Medicine and Psychiatry, University of California San Francisco; Division of Clinical Pharmacology, San Francisco General Hospital Medical Center, San Francisco, California, USA
| | - Neal L Benowitz
- Departments of Medicine and Bioengineering & Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA
| | - Eunha Hoh
- Division of Environmental Health, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Angela L Stotts
- Department of Family and Community Medicine, Department of Psychiatry and Behavioral Sciences, UTHealth Medical School, Houston, Texas, USA
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Sonmez CI, Aydin LY, Turker Y, Baltaci D, Dikici S, Sariguzel YC, Alasan F, Deler MH, Karacam MS, Demir M. Comparison of smoking habits, knowledge, attitudes and tobacco control interventions between primary care physicians and nurses. Tob Induc Dis 2015; 13:37. [PMID: 26566385 PMCID: PMC4642762 DOI: 10.1186/s12971-015-0062-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 11/04/2015] [Indexed: 11/10/2022] Open
Abstract
Background Primary care providers are uniquely positioned to initiate smoking cessation. We aimed to evaluate knowledge levels about the health effects of smoking and attitudes toward smoking and tobacco control activities among primary care providers. Methods In the cross-sectional and primary care-based study, self-administered surveys modified from the WHO Global Health Professional Survey 5A steps of smoking cessation practice (Ask, Advise, Assess, Assist and Arrange) were provided to primary care physicians (PCPhs) and nurses (PCNs). Results Respondents included 1182 PCPhs and 1063 PCNs. The proportions of current and former smokers were significantly higher among PCPhs than among PCNs (34.4 vs. 30.7 % and 14.0 vs. 10.1 %, respectively; both P < 0.001). We observed that 77.2 % of PCPhs and 58.4 % of PCNs always or rarely practiced an “Ask” step about their patients’ smoking status (P < 0.001). One-third of PCPhs (33.8 %) stated that they always practiced an “Ask” step, whereas only 27.6 % of PCNs always did so in their practice (P < 0.001). A small minority of primary care providers had advised patients to quit smoking, although there was a significant difference in this between PCNs and PCPhs (8.4 vs. 15.6 %; P < 0.001). Most PCPhs considered themselves competent in advising about smoking interventions, but only a minority of PCNs did so (75.1 vs. 17.3 %; P < 0.001). Among barriers to tobacco intervention measures, lack of time was the item most commonly cited by PCPhs, whereas low patient priority was most commonly cited by PCNs (35.9 and 35.7 %; P < 0.001). Conclusions Smoking intervention practice by primary care nurses was quite low. Lack of time and low patient priority were identified as barriers by primary care providers. Strategies by which primary care providers could improve tobacco control should be established.
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Affiliation(s)
- Cemil Isik Sonmez
- Department of Family Medicine, Duzce University, School of Medicine, Duzce, Turkey
| | - Leyla Yilmaz Aydin
- Department of Chest Diseases, Duzce University, School of Medicine, Duzce, Turkey
| | | | - Davut Baltaci
- Department of Family Medicine, Duzce University, School of Medicine, Duzce, Turkey
| | - Suber Dikici
- Department of Neurology, Duzce University, School of Medicine, Duzce, Turkey
| | | | - Fatih Alasan
- Department of Chest Diseases, Duzce University, School of Medicine, Duzce, Turkey
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Bostan PP, Demir CK, Elbek O, Akçay Ş. Association between pulmonologists' tobacco use and their effort in promoting smoking cessation in Turkey: a cross-sectional study. BMC Pulm Med 2015; 15:143. [PMID: 26558993 PMCID: PMC4642737 DOI: 10.1186/s12890-015-0131-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
Background A strategy to reduce the number of smoking-related deaths is to encourage the involvement of health-care professionals in tobacco-use prevention activities and cessation counseling. Previous studies have shown that physicians’ smoking status affects their efforts to provide smoking cessation counseling. This study investigates the association between pulmonologists’ tobacco use and their efforts in promoting smoking cessation during their routine clinical practices in Turkey. Methods This cross-sectional study was performed among active members of the Turkish Thoracic Society (TTS) between June 2010 and February 2011 using an Internet-based self-administered questionnaire. Participants gave their written informed consent. The survey included questions about responders’ sociodemographics, smoking status, and their routine clinical practice for smoking cessation counseling using the basic 5A’s (Ask, Advise, Assess, Assist, and Arrange) of smoking cessation counseling. According to the total score for the 5A’s protocol, smoking cessation counseling was dichotomized into low- and high-effort groups in promoting smoking cessation. Pearson’s chi-square test and t-test were used to compare groups and logistic regression models for the research question, which was approved by the TTS Scientific Ethical Committee. Results The response rate was 41 % (N = 699/1701); 9.9 % were current smokers, and 72.7 % indicated that they provided high effort in promoting smoking cessation. A univariate analysis showed that noncurrent smokers were more likely to make a high effort than current smokers (odds ratio [OR], 1.82; 95 % confidence interval [CI]: 1.09–3.05; P = 0.02). However, there was no association between tobacco use (current smoking) and making high effort in promoting smoking cessation after controlling for the two confounders, sex and practicing in smoking cessation outpatient clinic (OR, 1.47; 95 % CI: 0.86–2.50; P = 0.1). Conclusions Despite low response rate in our study and suspicions of underreporting, the smoking rate among the pulmonologists in our study was high. Non-current smokers were more likely to provide high effort in promoting smoking cessation compared to current smokers in univariate analysis. However, after controlling for the two confounders, sex and practising in SCOC, there was no association between tobacco use and providing high effort in promoting smoking cessation. Thus, improving medical school education, specialty training and post-graduate training on smoking cessation counseling may positively affect physician' effort in promoting smoking cessation.
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Affiliation(s)
| | - Canan Karaman Demir
- Occupational Diseases Education Clinic, Ankara Atatürk Chest Diseases and Thoracic Surgery Training Hospital, Ankara, Turkey.
| | - Osman Elbek
- Pulmonary Medicine, Medical Faculty, Adnan Menderes University, Aydın, Turkey.
| | - Şule Akçay
- Pulmonary Medicine, Medical Faculty, Başkent University, Ankara, Turkey.
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Schiano-Lomoriello V, Esposito R, Santoro C, de Simone G, Galderisi M. Early markers of right heart involvement in regular smokers by Pocket Size Imaging Device. Cardiovasc Ultrasound 2015; 13:33. [PMID: 26201963 PMCID: PMC4511232 DOI: 10.1186/s12947-015-0024-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 06/23/2015] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To test the diagnostic power of Pocket Size Imaging Device (PSID) in detecting early signs of right heart (RH) involvement in regular smokers (RS) free of overt cardiac involvement. METHODS One-hundred-forty-three regular smokers and 51 healthy controls, comparable for age and sex, underwent physical exam (PE), PSID exam and standard echocardiography. Based on a simplified Boston score, ≥1 of clinical signs (jugular venous distension, hepatomegaly, peripheral pitting oedema and abnormal pulmonary sounds) were considered indicative of RH involvement. A composite score (1 to 4) obtained by summing the points of four quantitative RH abnormalities detectable by PSID (inferior vena cava [IVC] dilatation, reduced IVC respiratory variation, right ventricular dilatation and right atrial dilatation), was generated and ≥1 of PSID abnormal signs was considered indicative of RH involvement. RESULTS Boston score was not significantly different between the two groups. By using PSID, smokers exhibited greater IVC diameter (p < 0.0001), right atrial diameter (p < 0.002) and higher PSID score (p < 0.005) than controls. Compared to PE, the additional diagnostic power of PSID (≥1 abnormal sign of both Boston and PSID score) was 44.9% in smokers. By dividing smokers in tertiles according to number of cigarettes per day, the third tertile showed the largest values of both IVC and right atrial dimension. Differences were confirmed by standard echocardiography. Reproducibility of PSID measurements and concordance of linear measurements between PSID and standard echo measurements was very good except for concordance of right ventricular basal diameter. CONCLUSIONS PSID detects early ultrasound signs of RH involvement in regular otherwise healthy smokers in comparison with PE.
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Affiliation(s)
- Vincenzo Schiano-Lomoriello
- Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Roberta Esposito
- Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Ciro Santoro
- Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Giovanni de Simone
- Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Maurizio Galderisi
- Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy.
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini 5,bld 1, Naples, 80131, Italy.
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Movsisyan NK, Petrosyan V, Harutyunyan A, Petrosyan D, Stillman F. Clearing the air: improving smoke-free policy compliance at the national oncology hospital in Armenia. BMC Cancer 2014; 14:943. [PMID: 25495431 PMCID: PMC4320561 DOI: 10.1186/1471-2407-14-943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 12/08/2014] [Indexed: 11/10/2022] Open
Abstract
Background Smoke-free policies shown to reduce population exposure to secondhand smoke (SHS) are the norm in hospitals in many countries around the world. Armenia, a transition economy in the South Caucasus, has one of the highest male smoking rates in the European region. Although smoking in healthcare facilities has been banned since 2005, compliance with this ban has been poor due to lack of implementation and enforcement mechanisms and social acceptability of smoking. The study aimed to develop and test a model intervention to address the lack of compliance with the de jure smoking ban. The national oncology hospital was chosen as the intervention site. Methods This study used employee surveys and objective measurements of respirable particles (PM2.5) and air nicotine as markers of indoor air pollution before and after the intervention. The intervention developed in partnership with the hospital staff included an awareness campaign on SHS hazards, creation of no-smoking environment and building institutional capacity through training of nursing personnel on basics of tobacco control. The survey analysis included paired t-test and McNemar’s test. The log-transformed air nicotine and PM2.5 data were analyzed using paired t-test. Results The survey showed significant improvement in the perceived quality of indoor air, reduced worksite exposure to SHS and increased employees’ awareness of the smoke-free policy. The number of employees reporting compliance with the hospital smoke-free policy increased from 36.0% to 71.9% (p < 0.001). The overall indoor PM2.5 concentration decreased from 222 μg/m3 GM (95% CI = 216-229) to 112 μg/m3 GM (95% CI = 99-127). The overall air nicotine level reduced from 0.59 μg/ m3 GM (95% CI = 0.38-0.91) to 0.48 μg/ m3 GM (95% CI = 0.25-0.93). Conclusions The three-faceted intervention developed and implemented in partnership with the hospital administration and staff was effective in reducing worksite SHS exposure in the hospital. This model can facilitate a tangible improvement in compliance with smoke-free policies as the first step toward a smoke-free hospital and serve as a model for similar settings in transition countries such Armenia that have failed to implement the adopted smoke-free policies. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-943) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Narine K Movsisyan
- School of Public Health, American University of Armenia, Yerevan, Armenia.
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Huddle TS, Kertesz SG, Nash RR. Health care institutions should not exclude smokers from employment. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:843-847. [PMID: 24871233 DOI: 10.1097/acm.0000000000000247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Some health care institutions, including academic health centers, have adopted policies excluding smokers from employment. Claims advanced on behalf of these policies include financial savings from reduced health costs and absenteeism as well as advantages consonant with their message of healthy living. The authors suggest that the institutional savings from these policies are speculative and unproven. Also, in settings where large medical schools operate, it is likely to be the poor, including members of minority groups, who, under an employee smoker ban, will lose the opportunity to work for an employer that offers health insurance and other benefits. In response to the incentives created by such bans, some will quit smoking, but most will not. Thus, at the community level, employee smoker bans are more likely to be harmful than beneficial.Although private businesses may rightly choose not to hire smokers in the 19 states where such policies are legal, health care institutions, including academic health centers, should consider hiring choices in light of the values they profess. The traditional values of medicine include service to all persons in need, even when illness results from addiction or unsafe behavior. Secular academic communities require a shared dedication to discovery without requiring strict conformity of private behavior or belief. The authors conclude that for health care institutions, policies of hiring smokers and helping them to quit are both prudent and expressive of the norms of medical care, such as inclusion, compassion, and fellowship, that academic health professionals seek to honor.
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Affiliation(s)
- Thomas S Huddle
- Dr. Huddle is professor of medicine, University of Alabama at Birmingham School of Medicine and Birmingham VA Medical Center, Birmingham, Alabama. Dr. Kertesz is associate professor of medicine, Birmingham VA Medical Center and University of Alabama at Birmingham School of Medicine, Birmingham, Alabama. Dr. Nash is Hagop Mekhjian Chair in Medical Ethics and Professionalism and director, Ohio State University Center for Bioethics, Columbus, Ohio
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Shahbazi S, Arif AA, Portwood SG, Thompson ME. Risk factors of smoking among health care professionals. J Prim Care Community Health 2014; 5:228-33. [PMID: 24695770 DOI: 10.1177/2150131914527618] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health care professionals (HCPs) play a vital role at various levels of smoking cessation programs to reduce tobacco use in general populations. However, their smoking habits may limit their ability to intervene with their patients who smoke. AIMS To determine prevalence rates of current smoking and examine sociodemographic and work-related factors associated with current smoking among HCPs. METHODS A statewide survey was conducted in a representative sample of 4 groups of HCPs, physicians, nurses, respiratory therapists, and occupational therapists, with active licenses in Texas in 2003. Weighted prevalence estimates of current smoking rates were computed. Survey logistic regression analysis was used to investigate associations between individual characteristics and current smoking. RESULTS There were 3600 HCPs included in the analysis. The overall prevalence of current smoking was 9% with the highest prevalence (16%) recorded among respiratory therapists and the lowest prevalence (3%) recorded among physicians. In the multivariable logistic regression analysis non-Hispanic white HCPs were almost 4 times as likely to be current smokers (adjusted odds ratio= 3.95, 95% confidence interval = 1.24-12.59) and those working for 50 hours or more per week were twice as likely to be current smokers (adjusted odds ratio = 2.07, 95% CI = 1.20-3.57). Compared with physicians, all other HCP groups had significantly greater odds of currently smoking. HCPs who were female and resided or worked in rural settings had higher smoking rates in univariable analysis only (P < .05). CONCLUSIONS Smoking is prevalent among certain HCP groups. Working long hours was identified as an important occupational factor associated with current smoking.
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Affiliation(s)
- Sara Shahbazi
- University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Ahmed A Arif
- University of North Carolina at Charlotte, Charlotte, NC, USA
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Khan MS, Bawany FI, Ahmed MU, Hussain M, Bukhari N, Nisar N, Khan M, Raheem A, Arshad MH. The frequency of smoking and common factors leading to continuation of smoking among health care providers in tertiary care hospitals of Karachi. Glob J Health Sci 2014; 6:227-34. [PMID: 24762367 PMCID: PMC4825474 DOI: 10.5539/gjhs.v6n3p227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 01/22/2014] [Accepted: 01/17/2014] [Indexed: 11/12/2022] Open
Abstract
Background: The primary objective of the study was to find out the frequency of tobacco smoking among health care providers in tertiary care hospitals of Karachi. The secondary objective was to identify the common factors responsible for the continuation of smoking. Method: This cross sectional study was conducted in the wards and out-patient departments of three selected tertiary hospitals of Karachi. A total of 180 health care providers were enrolled in the study using proportionate stratified sampling. Postgraduate students, house officers and trainees were excluded from the study. Data were collected from randomly selected health care providers using survey methodology. SPSS v. 20.0 was used to enter and analyze the data. Results: Fifty two participants out of 180 were smokers for past one year (28.9%). Among them, 21 (11.7%) smoked more than 5 cigarettes per day. Twenty smokers (11.1%) were found to smoke due to peer influence. It was found that those who were influenced by their peers were 8.33 times more prone to be addicted to smoking than those who were less influenced. Similarly, the likelihood of addiction increased up to 76.9% with the lack of incentives. Conclusion: Our results clearly indicate that a large number of health care providers smoke which should be a serious concern. Hence our health agencies should take immediate action in order to curtail the heaving burden of smoking and its related health consequences.
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Merlo LJ, Cummings SM, Cottler LB. Prescription drug diversion among substance-impaired pharmacists. Am J Addict 2014; 23:123-128. [PMID: 25187048 PMCID: PMC10308432 DOI: 10.1111/j.1521-0391.2013.12078.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/20/2013] [Accepted: 03/16/2013] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Prescription drug addiction is a significant problem affecting healthcare professionals. The purpose of the present study was to identify common mechanisms of prescription drug diversion by pharmacists, in order to facilitate the development of effective prevention programs and policies for this high-risk group. METHODS A total of 32 pharmacists (71% male) who were being monitored by their State professional health program (PHP) due to substance-related impairment participated in anonymous guided group discussions. RESULTS Participants documented six primary methods of drug diversion by pharmacists: (1) taking expired drugs that can no longer be sold by the pharmacy and are awaiting disposal; (2) assuming responsibility for managing the pharmacy inventory and/or changing inventory records to prevent detection of missing drugs; (3) forging prescriptions for themselves, family members, friends, or customers in order to gain access to the drugs; (4) using "sleight of hand" techniques to acquire drugs while filling prescriptions or shelving products; (5) blatantly stealing drugs from the pharmacy, even in front of coworkers or video cameras, and (6) collecting patients' unused medications and keeping them. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Efforts to address the problem of prescription drug abuse and diversion by pharmacists should be expanded in order to safeguard pharmacies and the patients they serve. Future research should extend this study to larger samples and assess best practices for decreasing prescription drug diversion by pharmacists with addiction.
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Affiliation(s)
- Lisa J. Merlo
- University of Florida Department of Psychiatry, Gainesville, Florida
- Professionals Resource Network, Inc., Fernandina Beach, Florida
| | | | - Linda B. Cottler
- University of Florida Department of Epidemiology, Gainesville, Florida
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Vitzthum K, Koch F, Groneberg DA, Kusma B, Mache S, Marx P, Hartmann T, Pankow W. Smoking behaviour and attitudes among German nursing students. Nurse Educ Pract 2013; 13:407-12. [DOI: 10.1016/j.nepr.2012.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 11/02/2012] [Accepted: 12/17/2012] [Indexed: 10/27/2022]
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McBane SE, Corelli RL, Albano CB, Conry JM, Della Paolera MA, Kennedy AK, Jenkins AT, Hudmon KS. The role of academic pharmacy in tobacco cessation and control. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2013; 77:93. [PMID: 23788804 PMCID: PMC3687126 DOI: 10.5688/ajpe77593] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 02/27/2013] [Indexed: 05/11/2023]
Abstract
Despite decades of public health initiatives, tobacco use remains the leading known preventable cause of death in the United States. Clinicians have a proven, positive effect on patients' ability to quit, and pharmacists are strategically positioned to assist patients with quitting. The American Association of Colleges of Pharmacy recognizes health promotion and disease prevention as a key educational outcome; as such, tobacco cessation education should be a required component of pharmacy curricula to ensure that all pharmacy graduates possess the requisite evidence-based knowledge and skills to intervene with patients who use tobacco. Faculty members teaching tobacco cessation-related content must be knowledgeable and proficient in providing comprehensive cessation counseling, and all preceptors and practicing pharmacists providing direct patient care should screen for tobacco use and provide at least minimal counseling as a routine component of care. Pharmacy organizations should establish policies and resolutions addressing the profession's role in tobacco cessation and control, and the profession should work together to eliminate tobacco sales in all practice settings where pharmacy services are rendered.
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Affiliation(s)
- Sarah E McBane
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California - San Diego, La Jolla, California, USA
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Hanioka T, Ojima M, Kawaguchi Y, Hirata Y, Ogawa H, Mochizuki Y. Tobacco interventions by dentists and dental hygienists. JAPANESE DENTAL SCIENCE REVIEW 2013. [DOI: 10.1016/j.jdsr.2012.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Making a difference: Nursing scholarship and leadership in tobacco control. Nurs Outlook 2013; 61:31-42. [DOI: 10.1016/j.outlook.2012.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 04/30/2012] [Accepted: 05/29/2012] [Indexed: 11/18/2022]
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Sarna L, Bialous SA. A review of images of nurses and smoking on the World Wide Web. Nurs Outlook 2012; 60:S36-46. [PMID: 23036793 DOI: 10.1016/j.outlook.2012.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 06/04/2012] [Accepted: 06/11/2012] [Indexed: 11/16/2022]
Abstract
With the advent of the World Wide Web, historic images previously having limited distributions are now widely available. As tobacco use has evolved, so have images of nurses related to smoking. Using a systematic search, the purpose of this article is to describe types of images of nurses and smoking available on the World Wide Web. Approximately 10,000 images of nurses and smoking published over the past century were identified through search engines and digital archives. Seven major themes were identified: nurses smoking, cigarette advertisements, helping patients smoke, "naughty" nurse, teaching women to smoke, smoking in and outside of health care facilities, and antitobacco images. The use of nursing images to market cigarettes was known but the extent of the use of these images has not been reported previously. Digital archives can be used to explore the past, provide a perspective for understanding the present, and suggest directions for the future in confronting negative images of nursing.
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Affiliation(s)
- Linda Sarna
- School of Nursing, University of California, Los Angeles, CA 90095, USA.
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Smoking prevalence, attitudes, and confidence about tobacco roles among Australian nursing students. J Addict Nurs 2012; 23:181-90. [PMID: 24335735 DOI: 10.1097/jan.0b013e31826f4b83] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study identified major challenges to be addressed before student nurses can achieve their full potential in providing effective and comprehensive smoking cessation interventions. Smoking behaviors were assessed among undergraduate nursing students. In addition, students' attitudes, confidence levels, and support for extra training in tobacco control were examined. A nonprobability sample of 381 students at an Australian university was surveyed. The consent rate was 81%. Prevalence of current smoking was 21%. In the regression analysis, age group was the only statistically significant predictor of smoking status. Over one third (36%) did not endorse the nonsmoking exemplar role of their future profession. Most (60%) did not support the concept of routine smoking cessation intervention. Students who were smokers had significantly higher tobacco control confidence levels than nonsmokers. Smoking-related variables did not differ between students in different years of the course. Improved tobacco control training is needed at undergraduate level.
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Knowledge, Attitudes, and Behavior Toward Smoking Cessation among Hospital Pharmacists in Taiwan. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.jecm.2012.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sarna L, Bialous S, Ong M, Wells M, Kotlerman J. Nurses' treatment of tobacco dependence in hospitalized smokers in three states. Res Nurs Health 2012; 35:250-64. [DOI: 10.1002/nur.21476] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2012] [Indexed: 11/10/2022]
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Sarna L, Bialous SA, Nandy K, Yang Q. Are quit attempts among U.S. female nurses who smoke different from female smokers in the general population? An analysis of the 2006/2007 tobacco use supplement to the current population survey. BMC WOMENS HEALTH 2012; 12:4. [PMID: 22429917 PMCID: PMC3328253 DOI: 10.1186/1472-6874-12-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 03/19/2012] [Indexed: 11/23/2022]
Abstract
Background Smoking is a significant women's health issue. Examining smoking behaviors among occupational groups with a high prevalence of women may reveal the culture of smoking behavior and quit efforts of female smokers. The purpose of this study was to examine how smoking and quitting characteristics (i.e., ever and recent quit attempts) among females in the occupation of nursing are similar or different to those of women in the general population. Methods Cross-sectional data from the Tobacco Use Supplement of the Current Population Survey 2006/2007 were used to compare smoking behaviors of nurses (n = 2, 566) to those of non-healthcare professional women (n = 93, 717). Smoking characteristics included years of smoking, number of cigarettes, and time to first cigarette with smoking within the first 30 minutes as an indicator of nicotine dependence. Logistic regression models using replicate weights were used to determine correlates of ever and previous 12 months quit attempts. Results Nurses had a lower smoking prevalence than other women (12.1% vs 16.6%, p < 0.0001); were more likely to have ever made a quit attempt (77% vs 68%, p = 0.0002); but not in the previous 12 months (42% vs 43%, p = 0.77). Among those who ever made a quit attempt, nurses who smoked within 30 minutes of waking, were more likely to have made a quit attempt compared to other women (OR = 3.1, 95% CI: 1.9, 5.1). When considering quit attempts within the last 12 months, nurses whose first cigarette was after 30 minutes of waking were less likely to have made a quit attempt compared to other females (OR = 0.69, 95% CI: 0.49, 0.98). There were no other significant differences in ever/recent quitting. Conclusions Smoking prevalence among female nurses was lower than among women who were not in healthcare occupations, as expected. The lack of difference in recent quit efforts among female nurses as compared to other female smokers has not been previously reported. The link between lower level of nicotine dependence, as reflected by the longer time to first cigarette, and lower quit attempts among nurses needs further exploration.
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Affiliation(s)
- Linda Sarna
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, Los Angeles, CA 90095, USA.
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Disparities in health behaviors and chronic conditions in health care providers in the Veterans Health Administration. J Occup Environ Med 2012; 53:1134-45. [PMID: 21926920 DOI: 10.1097/jom.0b013e31822b8379] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine baseline prevalence of health behaviors and chronic health conditions in Veterans Health Administration (VHA) employees and highlight disparities by occupation group. METHODS There were 29,834 responses to the survey. Age-standardized prevalence estimates for VHA employees were compared to national estimates from BRFSS surveys. The VHA estimates were analyzed for physicians and dentists; physician assistants and nurse practitioners; registered nurses; licensed practical nurses and nursing assistants; other clinical; nonclinical; and wage grade staff. Multilevel regression explored the effect of worksite. RESULTS The VHA employees have higher rates of unhealthy behaviors and chronic health conditions than US adults, except for smoking. Results illustrated significant disparities between occupation groups by demographics and variability by worksite. CONCLUSIONS Veterans Health Administration's population appears less healthy than the US general population. Disparities between occupation groups support the establishment of targeted health promotion programs, with attention paid to differences in local culture.
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Sarna L, Bialous SA. Response to Underwood S & Ryan T (2010) Commentary on Sarna L, Bialous SA, Wells M, Kotlerman J, Wewers ME & Froelicher ES (2009) Frequency of nurses’ smoking cessation interventions: report from a national survey. Journal of Clinical Nursing19, 294-296. J Clin Nurs 2011; 20:2087-9. [DOI: 10.1111/j.1365-2702.2010.03655.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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