Why do nurses smoke

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The Scrubs Staff would love to hear your ideas for stories! Please submit your articles or story ideas to us here. My summer break. Four common allergens at work—and how nurses can combat them. You may also like. First U. Nurses Are Quitting in Droves. Ten studies fulfilled the eligibility criteria and they were examined further.

Smoking has been identified by the World Health Organization as a global epidemic [ 1 , 2 ]. Nurses, as well as physicians, have an important role in educating their patients. They are seen as symbols of good health practice and they can influence the smoking habits of their patients by counseling them on smoking cessation interventions [ 4 ]. There are three main reasons that may explain why nurses smoke: stress caused by the working environment, peer and social influence and socioeconomic status and education [ 7 ].

Nurses who smoke perceive themselves as not being credible role models to help their patients quitting smoking. There are many studies demonstrating that a strong barrier to conducting smoking cessation interventions with the patients is the nurses themselves who continue to smoke and lack of confidence in their ability to support patients in their efforts to stop smoking [ 6 , 8 — 13 ].

Nurses who smoke seem to be less willing to take part in such practices and they are more likely to hold attitudes that might reduce the effects of their advice [ 14 , 15 ]. Nurses who smoke, may also be less supportive of smoke-free policy at health-care facilities [ 16 ].

Hospitals may be a potential factor that leads nursing staff to smoke in order to cope against stressful situations caused by the nursing environment. There is no clear link between working environment and tobacco use among nurses, as a lot of nurses have started smoking before entering hospitals, even before commencing training [ 7 , 20 — 23 ].

There were studies that presented the view that most of the nurses were women whose smoking was described to be related to stress at work, dissatisfaction with work and lack of social support [ 25 , 31 , 32 ].

The lack of controlling their own work, as well as stressful and high expectations increased smoking in women [ 33 ]. Although these studies tried to identify that the nursing environment may cause stress, they failed to comprehensively demonstrate a clear link between stress in the workplace and tobacco use [ 7 ].

Rowe and Macleod Clark performed a systematic review about the reasons that nurses smoke and they concluded that nurses were subject to the same kinds of stress as other females and thus were smoking for the same reasons [ 7 ]. The relationship between job stress and nicotine dependence could be stronger in hospitals with higher smoking prevalence among nurses, because it was speculated that nurses in such hospitals would be more allowed to smoke when feeling stressful during their assignment [ 34 ].

The review was undertaken using the computer database of the US National Library of Medicine Medline for the years —, with the help of the PubMed interface. The keywords were used all together and in pairs in order to retrieve the best possible number of studies. A single search string was not used, but we paired the different keywords in multiple ways.

Inclusion criteria were a priori defined in order to include or exclude the studies. The studies were searched without restrictions and then eliminated studies not in English or not with humans. Studies that did not meet these criteria were excluded from the review.

Two researchers, who were working separately, used a standardized data extraction form in order to extract data from every included study systematically. The researchers independently reviewed each of the titles and abstracts when they were available. Any disagreement was noted and discussed in a common meeting by the researchers. A major disagreement was the inclusion of two studies referred to nursing aids instead of nurses.

Moreover, these studies mentioned the smoking habit of nursing aids and the potential effect of stressful working environment, thus they were relative to the aim of the review, although the sample was not consisted of nurses.

Data extracted from each study included study main characteristics, study population, sampling method, hospitals or nursing wards, topic, statistics and conclusions.

The number of studies identified and selected or excluded in each phase of the research is shown in Figure 1. Additionally, seven studies were provided by manual searching of the bibliography. However, only two of them met the eligibility criteria and were ultimately included in the systematic review.

The main characteristics of the studies included in the systematic review are presented in Table 1. Four prospective cohort studies and four cross-sectional studies were included in the systematic review. Table 2 summarizes the main findings as well as the conclusions of the retrieved studies, regarding the association between the working environment as a stressor factor and the tobacco consumption by the nurses.

Job stress at the workplace was described in terms of psychological demand, decision latitude, supervisor support and coworker support [ 34 ] or by working more than 18 hours per week [ 36 ]. There were studies where job stress was described as working at night [ 38 ] or having heavy physical job strain [ 39 ]. Sarna et al. Smokers indicated higher levels of stress in the current job 6. Former smokers reported lower stress levels than current smokers 5. As Sarna et al. Ota et al.

In particular, there were four job stress scales: psychological demand, decision latitude, supervisor support and coworker support.

McKenna et al. Another study of McKenna et al. Work pressure was found to be the third reason 5. Tselebis et al. Five studies examined the role of work environment and work factors on smoking cessation among nurses. Sanderson et al. Cofta and Staszewski found that hospital staff being on call or working at night were consuming more cigarettes per day than those who were not working at night Workplace, as a stress factor, was examined either as a motivator for starting or increasing smoking habits among nursing staff, or as a barrier for cessation tobacco use.

That fact could possibly explain the existence of the conflict regarding the potential relationship of stress caused by the workplace and the smoking habits of the nursing staff. Studies dealing with the work stress and the smoking behavior of nurses have revealed a link between them. Nurses with increased levels of high psychological demand may crave tobacco, smoke and became psychologically more dependent on smoking in order to diminish symptoms of mental stress caused by the workplace.

Moreover, the relationship between job stress and tobacco use could be stronger in hospital with high smoking prevalence among nurses and among shift workers. Tobacco use may be a way of stress management instead of using other measures of stress reduction [ 34 ]. Smoking was described as a way of taking out and coping with the stressful environment of the busy hospital.

According to McKenna et al. It seems that job stress had little effect in the etiology of smoking behavior among nurses [ 20 ]. Although a strong positive correlation between anxiety scores and smoking that retrieved an anxiolytic influence of smoking was found by the study of Tselebis et al.

As Steward et al mentioned, smoking has been associated with the relief of anxiety in unselected populations, especially in women [ 43 ]. It is well known that smoking is highly addictive and has been marketed as something to promote calm and take a break. Cofta and Staszewski mentioned that hospital staff was smoking more cigarettes in their attempt to find a way of getting away from stress at work.

Increased risk of experiencing negative emotions could explain an increased risk of relapse [ 37 ]. Moreover, long working hours may evoke emotional distress, a well-known inhibitor of smoking cessation [ 44 ].

This question has been investigated by research with regards to nurses. The evidence shows that nurses often start smoking before undertaking their training, and do so for many of the same reasons other young women and people in general start smoking. Being a nurse or a doctor can also be very stressful, so this likely has a role to play too. However, smoking rates in doctors and registered nurses are declining. There are ethical and professional issues relating to smoking by doctors and nurses.

For ethical issues, the most obvious is that it could be seen as hypocritical. Doctors and nurses smoking is seen by some people as undermining their credibility when telling patients about the dangers of smoking and why they should quit. In short, many argue that doctors and nurses should be better role models for their patients. However, there is some disagreement on this issue. As long as they give sound medical advice on the dangers of smoking, does it really matter what they do in their personal life?

Regardless of your view on the ethical issues, from a practical perspective, many healthcare providers either ban smoking on their grounds or even refuse to hire smokers.

This makes quitting a priority for many doctors and nurses who smoke.