Contemporary smoking habits among nurses in Mainland China

An international review of tobacco smoking research in the nursing profession, 1976-2006

Tobacco smoking represents a contentious issue in the nursing profession, and one that has now become an important topic in nursing research. Despite this fact, the epidemiological quality of research varies widely, and it has been difficult to accurately determine the true incidence of smoking among nurses. Given these inconsistencies, we conducted a state-of-the-art review to identify international trends in tobacco usage among nurses, to ascertain how the epidemiological quality of research has improved over the past 30 years, and also to elucidate the directions in which nursing research has evolved. A total of 73 English-language studies that met the inclusion criteria were located and analysed. Overall, our review suggests that, while tobacco smoking among nurses appears to be decreasing in many countries during recent years, the international trend is far from uniform, and some developed nations still report high smoking rates among their nursing staff. From a methodological perspective, the relative epidemiological quality of smoking research has also fluctuated over time, making it difficult to compare the results of one study to the next. Despite these caveats, tobacco smoking remains a key topic in nursing research, as well as a critically important occupational-health issue for the entire nursing profession. In order to make the next generation of tobacco research data as comparable as possible, future scholars should consider devising and implementing a standardised format for conducting international tobacco smoking research within the nursing profession.

Razširjenost Kajenja Med Medicinskimi Sestrami, Babicami In Zdravstvenimi Tehniki V Sloveniji / The Prevalence Of Smoking Among Nurses, Midwives And Nursing Technicians In Slovenia

Uvod: Medicinske sestre lahko s svetovanjem za opustitev kajenja pomembno prispevajo k zmanjšanju rabe tobaka; pri tem jih pomembno ovira njihovo lastno kajenje. Namen raziskave je prikazati kadilske navade te poklicne skupine v Sloveniji.

Metode: Analiza temelji na podatkih iz presečne raziskave na nacionalno reprezentativnem vzorcu medicinskih sester, babic in zdravstvenih tehnikov (spletna anketa). Naključno izbrani člani Zbornice zdravstvene in babiške nege so se odzvali v 51% (N =1.500), o tem, ali kadijo ali ne, pa smo dodatno pridobili podatke še od 218 oseb, ki sicer v anketi niso želele sodelovati.

Rezultati: V Sloveniji kadi 20,9% medicinskih sester, babic in zdravstvenih tehnikov, več moških (32,9%) kot žensk (19,6%), več tistih s srednjo stopnjo izobrazbe (25,1%) kot z višjo ali več (12,1%), z nižjo samooceno materialnega standarda, ki ne živijo s partnerjem in ki nimajo (predšolskih) otrok ter med njihovimi najbližjimi sodelavci, prijatelji in sorodniki kadi nadpovprečen delež oseb. Več kot polovica (52,9%) jih je začela kaditi med šolanjem na srednjih šoli, znaten delež (15,6%) pa tudi v prvih letih zaposlitve. 20% jih navaja, da v ustanovi, v kateri delajo, zaposleni kršijo prepoved kajenja.

Zaključek: Kajenje med medicinskimi sestrami, babicami in zdravstvenimi tehniki je v Sloveniji še vedno prepogost pojav ter lahko znatno vpliva na njihovo poslanstvo in delo na področju promocije nekajenja in pomoči pri opuščanju kajenja. Pomembno je, da za to poklicno skupino okrepimo promocijo nekajenja že od začetka šolanja in organiziramo ustrezne programe opuščanja kajenja.

Tobacco smoking among doctors in mainland China: a study from Shandong province and review of the literature

BACKGROUND

Tobacco control represents a key area in which doctors can make a significant positive impact on their patients' lives. Despite this fact, however, doctors in certain regions of China are known to smoke tobacco at rates similar to or even exceeding those seen within the general population.

OBJECTIVE

This study sought to investigate the smoking habits of doctors at a teaching hospital in Shandong province, as well as providing a brief review of smoking research that has been conducted among doctors elsewhere in China.

METHOD

An anonymous questionnaire survey was distributed to doctors working at a university teaching hospital in 2008, as part of a larger study of occupational health issues in the healthcare profession.

RESULTS

The overall smoking prevalence rate of doctors in this study was 36.3% with significant differences observed between the genders (males: 46.7% and females: 5.3%). Age and total career length were also correlated with smoking habit, although no significant associations were found with department of employment.

CONCLUSIONS

Overall, our study suggests that smoking rates among doctors in Shandong province are higher than those documented in many other countries, a finding which is consistent with previous research conducted in some other Chinese provinces. Addressing this issue from an intrinsic cultural perspective will clearly need to form the cornerstone of tobacco control efforts within the Chinese medical community in future years.

Smoking among doctors: governmentality, embodiment, and the diversion of blame in contemporary China

How and to what effect have physicians in China become frequent cigarette smokers and blamed as engines of nationwide tobacco-induced suffering? Building on governmentality heuristics, I argue that multilevel interactions of biopolitics and male embodiment have been especially significant in shaping these phenomena. Of the effects gleaned in my fieldwork ongoing since 2003, the most important is a deflection of responsibility for tobacco-induced death away from incoherent leadership decisions--some aimed at protecting Chinese citizens from tobacco, others at facilitating trillions of cigarettes being sold annually in the PRC--made over recent years in and outside the country.

Nurses' Tobacco-Related Knowledge, Attitudes, and Practice in Four Major Cities in China

PURPOSE

To (a) identify Chinese nurses' tobacco-related knowledge, attitude, and practice (KAP), including perception of competency in smoking-cessation interventions; (b) identify barriers and facilitators to smoking cessation interventions to patients; and (c) assess the learning needs and smoking status of nurses.

DESIGN

A cross-sectional survey was conducted in four major cities (Beijing, Shanghai, Guangzhou, and Chongqing) in China from November to December 2003.

METHODS

2,888 registered nurses working in hospitals affiliated with five university schools of nursing in these cities were invited to complete a questionnaire. An instrument used to assess tobacco-related KAP in Hong Kong was translated into Chinese and pilot tested to ensure reliability and validity.

FINDINGS

2,179 questionnaires were returned and after exclusion of the grossly incomplete questionnaires, 1,690 were included in the present analysis. Only 2% of participants were current and 1% were former smokers; most had not received training for smoking-cessation interventions as part of their nursing education program. Two-thirds recognized smoking as a leading cause of preventable death and that smoking cessation was the most cost effective intervention, but only a third routinely assisted patients' quit attempts. Nurses who received training reported greater competence in providing smoking-cessation intervention, and more frequent practice of cessation interventions.

CONCLUSIONS

Chinese nurses had some knowledge about the health effects of tobacco use, but seldom practiced smoking-cessation interventions. Those who had prior training had greater competence and more practice. Including tobacco control, especially smoking cessation, in nursing curricula in China has the potential to save millions of lives.