Tobacco smoking habits, attitudes and beliefs among nurse and medical students in Tuscany

Toxic Habits and Well-Being Measures in Spanish Healthcare University Students during the COVID-19 Pandemic

BACKGROUND

Unhealthy lifestyles are strongly entrenched in healthcare universities and have sometimes been linked to stress or lack of sleep. This study investigated the prevalence of toxic habits (smoking, patterns of harmful alcohol use, and illicit drug use), stress levels, perceived health status, and sleep duration and assessed the connections between toxic habits and said well-being measures, as well as healthcare students' perception of the influence of the COVID-19 pandemic on these health-related behaviors.

METHODS

In a cross-sectional study, healthcare students from Alfonso X University (Spain) completed a health survey composed of Alcohol Use Disorders Identification Test (AUDIT-C), Perceived Stress Scale (PSS-10), self-perceived health status, and the number of hours of sleep.

RESULTS

A total of 997 healthcare students completed the survey, of which 982 were analyzed. Being a smoker (32.2%) was associated with worse health status and insufficient sleep. Risk drinkers (33.2%) were associated with being female, and the consumption of cannabinoids (6.7%), with being male. These three toxic habits were related to each other. High levels of stress (28.2%) were correlated with worse ratings in the perception of health status (29.2%) and with insufficient sleep (45.8%), and all of them were associated with the female sex. Respectively, 49.3% and 44.2% of students recognized a worsening in their perception of stress and their sleep habits during the pandemic.

CONCLUSION

Healthcare universities must carry out health promotion programs for stress management, sleep habits, and unhealthy lifestyles.

Patterns of Tobacco Smoking and Nicotine Vaping among University Students in the United Arab Emirates: A Cross-Sectional Study

Various forms of tobacco smoking and nicotine vaping tools are available on the market. This study quantified the prevalence of and identified factors associated with patterns of smoking and nicotine vaping among university students in the United Arab Emirates (UAE). A cross-sectional sample of students enrolled in three public universities was surveyed. Self-reported current smoking and nicotine vaping were recorded. Of 1123 students, 81.7% completed the online survey (mean age, 20.7 ± 3.4 (SD) years; 70.7% females). The prevalence of current smoking was 15.1% while the prevalence of current nicotine vaping was nearly 4.0%. Among current smokers, 54.7% reported conventional smoking only, 15.1% reported nicotine vaping only, and 28.8% were poly-users. Conventional midwakh (47.5%), followed by conventional shisha/waterpipe (36.7%), conventional cigarettes (36.7%), electronic shisha/waterpipe (25.2%), and electronic cigarettes (24.5%), were most commonly reported by students. Students aged 20–25 years (adjusted odds ratios (aOR): 2.08, 95% confidence interval (CI): 1.18–3.67) or >25 years (aOR: 4.24, 95% CI: 1.41–12.80) had higher odds of being current smokers compared to those aged 17–19 years. The male gender was also independently associated with higher odds of being a current smoker (aOR: 5.45, 95% CI: 3.31–8.97) as well as higher odds of smoking cigarettes, shisha, and midwakh, or nicotine vaping compared to being female. Of nicotine vaping users, 36.1% reported using nicotine vaping because they enjoyed the flavor and vaporizing experience and 34.4% used it to help them to quit smoking. A relatively high prevalence of self-reported smoking was reported among university students in the UAE. The findings also suggest that nicotine vaping use is relatively widespread, but still less common than traditional smoking. Vigilant and tailored university-based smoking control and preventive measures are warranted.

Mental Health Disturbances and Related Problems in Italian University Medical Students from 2000 to 2020: An Integrative Review of Qualitative and Quantitative Studies

Background and objectives: The presence of mental health problems in the population of medical students in Italy has been evaluated in several cross-sectional studies, which have used different methodologies and study designs. However, a global overview of the prevalence of mental health problems in Italian medical students is not available, although this would be essential for promoting preventive strategies and supportive treatments. Materials and Methods: An integrative review aiming to describe the prevalence of mental health problems in Italian medical students has been performed. Results: The most relevant findings are the high prevalence of substance use, in particular alcohol and nicotine, and of depressive and anxiety disorders in Italian medical students. In particular, substance use ranges from 13 to 86%, which is higher compared to Italian students coming from other faculties. Italian medical students show a high rate of smoking and of depressive symptoms of about 20%. Conclusions: Our findings highlight the need to develop appropriate supportive interventions for the medical student population, which are rarely provided and implemented among the routine activities of Italian medical universities. A relevant aspect to be considered is the stigma and anticipated discrimination attached to mental disorders, which reduce the help-seeking process in medical students.

Smoking behavior and secondhand smoke exposure among university students in northern Portugal: Relations with knowledge on tobacco use and attitudes toward smoking

OBJECTIVES

To assess the prevalence of active smoking and secondhand smoke (SHS) exposure among college students in the north of Portugal, and analyze the relationship between knowledge about tobacco use and attitudes toward smoking.

MATERIALS AND METHODS

This a cross-sectional study with a representative sample of college students (n=840) in one university in Portugal. A validated self-reported questionnaire was administered to a proportional stratified random sample during the academic year of 2018/2019. We evaluated associations between smoking status, SHS exposure, smokers peers, knowledge and attitudes toward smoking and sociodemographic variables.

RESULTS

The results showed that 20.1% of the students surveyed were current smokers (7.3% occasional smokers, 2.9% regular smokers and 9.9% daily smokers). Most current smokers started smoking before the age of 17 (61.4%) and reported never having tried to quit smoking (59.7%). Only 34.4% of students reported (almost) not having been in enclosed spaces with smokers in the past 7 days. Exposure to SHS and having smoker friends contributes to the prevalence of tobacco use. In general, students showed favorable attitudes toward smoking, especially those who are smokers, have smoking friends and are more exposed to SHS. The level of knowledge about tobacco was moderate, with a higher number of correct responses by former smokers.

CONCLUSIONS

These results suggests an urgent need for socio-educational programs for counseling on smoking cessation. In addition, is also strongly recommended that, throughout academic training, students develop personal and social skills for dealing with the tobacco epidemic.

The Prevalence of Smoking (Cigarette and Waterpipe) among University Students in Some Arab Countries: A Systematic Review

Background:

Tobacco use among university students remains the most alarming problem worldwide. This study aims to systematically review the previous literature for determining the prevalence of smoking (cigarette and waterpipe) among university students in some Arab countries.

Methods:

We electronically searched articles from MEDLINE, PubMed, EMBASE, Google Scholar and Google for the period from April 2018 to June 2019. We conducted a systematic review of eligible studies published in English between 2006 and 2019, for assessing cigarette and waterpipe smoking among university students. The studies were all cross-sectional according to eligibility criteria and contained 469 studies19 meet the inclusion criteria from 12 countries of (Yemen, Kingdom of Saudi Arabia (KSA), Kuwait, Bahrain, Jordan, Lebanon, Tunisia, Egypt, Palestine, Syria, Libya and United Arab Emirates (UAE).

Results:

the study included a total of participants (N=45,306) (33,450 Males vs 11,856 Females). The overall highest rate of current smoking among students was in Egypt (46.7%), Kuwait (46%) and KSA (42.3%). The smoking prevalence among males was significantly higher than females in Yemen (36.3% vs 28.0%,p<0.001), Bahrain (27.0%vs 4.2%, p<0.001), Tunisia (38.4% vs 3.4%, P<0.001), Egypt (61.2% vs 18.9%, P<0.001), Palestine (52.7% vs 16.5%, p<0.001), Syria (26.1% vs 9.5%, p<0.001), KSA (32.7%vs5.9%,P<0.001), and Jordan (54.3%vs11.1%, P<0.005) and (56.9%vs11.4%, P<0.005). Another study in Yemen was significantly higher among women than man (15.7% vs 10.3%, p<0.001). The highest waterpipe smoking rates among gender was in KSA (36.4%-36.3%). For cigarette smoking, the highest rates were in Libya (80.2%), Jordan (80%) and KSA (70.7%). The highest smoking rates among males were in Egypt (61.2%), Jordan (56.9%-54.3%) and Palestine (52.7%), for females the highest rate was in Yemen (28.0%).

Conclusion:

The prevalence of smoking cigarette and waterpipe appears to be alarmingly high among university students in Arab countries. The results were different among students, due to the nature of the region and the different customs, traditions, lineage and multicultural from country to another.

Prevalence of smoking in nursing students worldwide: A meta-analysis of observational studies

BACKGROUND

Smoking is common among nursing students worldwide, but the reported prevalence is inconsistent across epidemiological studies. This is a meta-analysis of the prevalence of smoking in nursing students worldwide.

DESIGN

Meta-analysis of observational studies.

SAMPLE

A total of 46 studies were included in this meta-analysis.

METHOD

Electronic databases (PubMed, Medline, PsycINFO, EMBASE and Web of science) were independently and systematically searched by two investigators from their commencement date up to 12 May 2018. Studies that reported the smoking rate of nursing students were included and analyzed using random-effects model.

RESULTS

The pooled prevalence of current smoking was 26.6% (95% CI: 22.9-30.4%), while pooled prevalence of previous smoking was 15.5% (95% CI: 11.8-19.3%). Subgroup analyses showed that smoking rate was higher in male compared with female students (39% vs 25.2%, P < .001), while survey time, sample size, age, study design and academic year did not moderate the smoking rate (all P > .05).

CONCLUSION

This meta-analysis confirmed that smoking is common in nursing students. Considering the negative impact of smoking on health, appropriate smoking cessation measures for nursing students should be developed.

Changes and specificities in health behaviors among healthcare students over an 8-year period

BACKGROUND

Healthcare students are future health care providers and serve as role models and coaches to enhance behaviors for healthy lifestyles. However healthcare students face multiple stressors that could lead to adopting risk behaviors.

OBJECTIVES

To assess the changes in health risk factors among healthcare students between 2007 and 2015, and to identify specific health behaviors based on the curriculum in a population of healthcare students.

METHODS

Two cross sectionnal studies were conducted in 2007 and 2015 among nursing, medical, pharmacy, and physiotherapy students (Rouen, France). During compulsory courses and examination sessions students filled self-administered questionnaires on socio-demographic characteristics and behavior as: tobacco smoking, alcohol consumption, cannabis consumption, eating disorders, regular practice of sport, perceived health, stress and use of psychotropic drugs.

RESULTS

2,605 healthcare students were included (1,326 in 2007 and 1,279 in 2015), comprising 1,225 medical students (47.0%), 738 nursing students (28.3%), 362 pharmacy students (13.9%), and 280 physiotherapy students (10.8%). Between 2007 and 2015, occasional binge drinking and regular practice of sport increased significantly among healthcare students, respectively AOR = 1.48 CI95% (1.20-1.83) and AOR = 1.33 CI95% (1.11-1.60), regular cannabis consumption decreased significantly, AOR = 0.32 CI95% (0.19-0.54). There was no change in smoking or overweight/obese. There was a higher risk of frequent binge drinking and a lower risk of tobacco smoking in all curricula than in nursing students. Medical students practiced sport on a more regular basis, were less overweight/obese, had fewer eating disorders than nursing students.

CONCLUSION

Our findings demonstrate a stable frequency of classic behaviors as smoking but a worsening of emerging behaviors as binge drinking among healthcare students between 2007 and 2015. Health behaviors differed according to healthcare curricula and nursing students demonstrated higher risks. As health behaviors are positively related to favorable attitudes towards preventive counseling, therefore healthcare students should receive training in preventive counseling and develop healthy lifestyles targeted according to the health curriculum.

GHPSS Multicenter Italian Survey: Smoking Prevalence, Knowledge and Attitudes, and Tobacco Cessation Training among Third-Year Medical Students

Aims and background

Healthcare professionals have an important role to play both as advisers – influencing smoking cessation – and as role models. The aims of this study were to examine smoking prevalence, knowledge and attitudes among Italian university students attending medical schools using the Global Health Professions Student Survey (GHPSS) approach.

Methods and study design

A multicenter cross-sectional study was conducted among University students of 9 Italian medical schools (age ranging between 19 and 29 years). The GHPSS questionnaire was self-administered. A logistic regression model was used to identify possible factors associated with tobacco smoking status. Data were analyzed with the software SPSS 19.0 for Windows.

Results

Seven hundred thirty medical students (response rate 100%) were enrolled. The prevalence of current smokers was 20.4% (males 22.4%, females 19.1%). Of the total sample, 87.7% believed that health professionals should receive specific training in techniques to quit smoking, and 65% believed that health professionals had a role in giving advice or information about smoking cessation. However, 89.4% answered that they had not received specific training on smoking cessation techniques. Multivariate analysis showed that students belonging to universities in southern Italy were more likely to be smokers (OR = 2.00; 95% CI: 1.03–3.97).

Conclusions

This Italian multicenter survey found that one fifth of future medical doctors are smokers. There is a need to adopt a standard undergraduate curriculum containing comprehensive tobacco prevention and cessation training to improve their effectiveness as role models.

Substance abuse amongst the medical graduate students in a developing country

Background & objectives:

Substance abuse is found worldwide including among students. We carried out this study to estimate the prevalence of substance abuse among medical student studying in a medical college in north India.

Methods:

Using a validated questionnaire a cross-sectional survey was conducted among 230 undergraduate and postgraduate medical students in a private medical college.

Results:

The prevalence of substance abuse was 20.43 per cent (47/230) among medical students. An increase in substance abuse was observed in the latter years of medical education. A total of 43 of 47 (91.7%) students using these substances were aware of the ill effects. The most common reasons for substance use were relief from psychological stress (34/47, 72.4%) and occasional celebration (34/47, 72.4%). Of the 47 substance users, 28 (59.6%) made past attempts to quit the substance abuse.

Interpretation & conclusions:

Nearly one-fifth of medical students abuse at least one substance despite knowing the ill effects with the main predisposing factor being the psychological stress.

Perceptions of Lung Cancer and Smoking Among College Students in Jordan

A descriptive, cross-sectional design was adopted to identify college students’ knowledge and perceptions of lung cancer and smoking. A random sample of 400 students at the Jordan University of Science and Technology in northern Jordan was subjected to the Lung Cancer and Smoking Survey, which is based on the Health Belief Model. The results show that the prevalence of current smoking is 16.5% and that the prevalence of former smoking is 10.0%. Most (75.3%) of the respondents were aware of the prevalence of lung cancer. Almost all (90.3%) were aware of the cancer risk from air pollution, but fewer (57.5%) were concerned about the risk caused by side-stream smoke. Most disagreed that lung cancer could be easily cured. Former smokers were more knowledgeable than current smokers about the health hazards of smoking, and those who never smoked were more knowledgeable than both. Engineering students were more likely to agree with the benefits of quitting smoking than were medical or science students. Addiction and friends were the reasons most frequently given for not quitting smoking.

Changes in use, knowledge, beliefs and attitudes relating to tobacco among nursing and physiotherapy students: a 10-year analysis

AIM

To analyse changes in prevalence, knowledge, beliefs and attitudes relating to smoking among undergraduate nursing and physiotherapy students over a 10-year period.

BACKGROUND

Few studies have been performed to describe changes in the use of tobacco and associated characteristics.

DESIGN

This study was a sequential cross-sectional study.

METHODS

A self-administered survey was performed during three academic years among nursing and physiotherapy students in a Spanish Faculty of Health Sciences.

FINDINGS

The proportion of smokers among nursing and physiotherapy students in 2003, 2008 and 2013 was 29·3%, 24·7% and 18·2% respectively. The ages when participants first smoked did not vary over the years. The Fagerström test showed low nicotine dependence. A significantly high percentage of students stated they were unaware of the link between smoking and bladder cancer and oral leukoplakia. Students declared they were unaware of the association between under-weight new-borns and second-hand smoke. The majority of students recognized that healthcare professionals were role models in society, there being little variation over the years studied. In relation to education and training, the study showed a need to inform students about methods and strategies to help people quit smoking.

CONCLUSIONS

The prevalence of smoking among nursing and physiotherapy students decreased over the ten years. Active programmes should be implemented to encourage those university students who smoke to break this habit. The decline over the years in knowledge about smoking provided evidence of a significant deficit in undergraduate training.

Do medical students know enough about smoking to help their future patients? Assessment of New York City fourth-year medical students' knowledge of tobacco cessation and treatment for nicotine addiction

PURPOSE

Practicing physicians underutilize U.S. Department of Health and Human Services evidence-based approaches to nicotine addiction and treatment. Few studies have assessed medical student knowledge in this area. This study examined New York City fourth-year medical students' knowledge of tobacco cessation and treatment of nicotine addiction.

METHOD

The authors conducted a Web-based survey, comprising 27 closed- and open-ended questions, of six of seven New York City medical schools in the spring of 2004. They drew questions from international, national, and local surveys on tobacco and health, U.S. Department of Health and Human Services tobacco treatment guidelines, and prior studies. Primary outcome measures were knowledge of the epidemiology of smoking, benefits of cessation and treatment of nicotine addiction, clinical cessation practices, and students' use of tobacco and intentions to stop smoking.

RESULTS

Of 943 fourth-year medical students, 469 (50%) completed an online survey. Students had good knowledge of the epidemiology of smoking, including its prevalence and health effects, with most responding correctly to relevant questions (mean correct response 79%; SD = 9.4). Students demonstrated a fair understanding of the benefits of cessation (mean correct response, 67%; SD = 19.2) and treatment of nicotine addiction (mean correct response, 61%; SD = 13.2). Three hundred students (64%) rated their own preparation to assist patients to quit as less than adequate.

CONCLUSIONS

Fourth-year medical students at the participating schools in New York City understood the harms of smoking but needed more information on the benefits of stopping smoking and treatment of nicotine addiction.

Smoking Among Vietnamese Medical Students: Prevalence, Costs, and Predictors

This cross-sectional study investigated smoking patterns and predictors among Vietnamese medical students. In total, 4720 medical students from 3 universities, each located in South, Central, and North Vietnam, were interviewed using an adapted Global Youth Tobacco Survey Questionnaire. Ideas on smoking behavior and tobacco control derived from group discussions with students and from unstructured interviews with student managers and university directors. Overall, the current smoking rate was 25.0% and dominant in men at 43.7%. Most started smoking when just entering university (18 ± 3.3 years). Male students from the central region had the highest smoking rate (35.1%), whereas their northern counterparts had the greatest smoking magnitude: age of smoking initiation (18.6 ± 3.5), number of cigarettes per day (4.4 ± 4.5), number of smoking days per month (16.5 ± 11.6), and proportion of smoking cost among total expenses per month (10.9% ± 11.9%). Smoking tended to increase across academic years, being highest in years 5 to 6 (35.0%). In contrast, the practice of ever quitting and the intention of quitting tended to decline from years 1-2 to years 5-6 (from 82.2% to 71.5%, P < .05, and from 70.8% to 51.5%, P < .001, respectively). Positive attitudes toward smoking (odds ratio = 1.4, P < .05), negative beliefs on hazards of smoking (odds ratio = 1.7), and daily exposure to family smokers (odds ratio = 2.0, P < .05) and to social smokers (odds ratio = 4.5, P < .05) were main predictors of smoking. Qualitative results suggest that nonsmoking university regulations played a critical role in tobacco control among medical students. Nonsmoking regulations and penalties for students who smoke need to be formulated at medical universities. The message that medical students must make a nonsmoking role model for community should be systematically promoted.

A systematic review of tobacco smoking among nursing students

This study was conducted to systematically and critically evaluate the large number of academic publications which have investigated tobacco smoking among nursing students in recent years. It was performed as a state-of-the-art examination of all modern literature published in peer-reviewed, English-language journals since 1990. Although smoking appears to be fairly common among nursing students, its prevalence and distribution varies widely depending on the country of study and time period during which the research was undertaken. Although there is some evidence to suggest that smoking rates increase by year of study in the nursing course, not all research has shown a clear association in this regard. Similarly, the value of anti-smoking interventions for nursing students appears to be limited, based on currently available information. Given these conflicting issues, further research which helps to ascertain why student nurses do not wish to give up their habit is clearly needed both locally and internationally. The development of an international smoking questionnaire may also be useful to help standardize future research on tobacco usage among this vulnerable demographic.

Smoking, drinking, sleeping habits, and other lifestyle factors and the risk of systemic lupus erythematosus in Japanese females: findings from the KYSS study

Many risk factors have been proposed for systemic lupus erythematosus (SLE). However, there is little information about the relationship between lifestyles and SLE in Japan. Two case control studies were conducted in Kyushu, southern Japan, and in Hokkaido, northern Japan, to examine the relationship between lifestyles and development of SLE in females. The participants were 78 patients and 329 controls in Kyushu and 35 patients and 188 controls in Hokkaido. Smoking was associated with an increased risk of SLE after adjusting for age in both regions. However, in Hokkaido, this association between smoking and SLE did not reach statistical significance after adjusting for alcohol drinking. The present study suggests that smoking may increase the risk of SLE among Japanese females.

A cluster-randomized trial on smoking cessation in German student nurses

OBJECTIVES

To evaluate the effect of a specific intervention on smoking cessation in health professionals.

METHODS

Between 2003 and 2004, a cluster-randomized trial was performed in 32 schools of nursing with 956 student nurses in Southwest Germany. Students in the intervention group received three teaching units each lasting 1 day on how to give advice to people who want to stop smoking. The program addressed only nurses' professional role and not their individual smoking behavior. After a follow-up of 13 months, the change in smoking status was determined. Secondary endpoints included changes of smoking-related factors like stages of smoking or knowledge about health risks.

RESULTS

Change of smoking status in the desired direction (stopping smoking or not starting smoking) occurred less often in the intervention than in the control group, but the difference did not reach statistical significance (odds ratio 0.69, 95% confidential interval: 0.43, 1.10). The program was successful in delivering medical knowledge (P=0.0056) and in enhancing competence in giving advice to smokers (P<0.0001).

CONCLUSIONS

The applied approach is able to improve student nurses' medical knowledge and to augment their competence in giving advice to smokers, but it is not an effective strategy to reduce their own smoking behavior.

The effects of a non-smoking policy on nursing staff smoking behaviour and attitudes in a psychiatric hospital

The UK Department of Health required that by April 2001, all NHS bodies would have implemented a smoking policy. It has been suggested that the best demonstration a hospital can make of its commitment to health is to ban smoking on its premises. This paper reports on an evaluation of the effectiveness of a non-smoking policy in a newly opened NHS psychiatric hospital. Questionnaires were sent to all 156 nursing staff in a psychiatric hospital to assess the effectiveness of the policy in terms of staff smoking behaviour, attitudes to the restriction and compliance with the policy. Of the 156 questionnaires distributed, 92 (58%) were returned; smokers, former smokers and those who have never smoked were quite evenly represented at 34.78%, 34.78% and 30.43%, respectively. Of eight critical success factors for the policy, only one, staff not smoking in Trust public areas, had been achieved. A non-smoking policy was generally accepted as necessary by nursing staff working in a mental health setting. Staff felt that the policy was not effective in motivating smoking nurses to stop and that insufficient support was given to these nurses. The study highlights the importance of introducing staff support systems as an integral part of smoking policies and the role of counterintuitive behaviour in the effectiveness of smoking policy introduction in healthcare settings.

Cognitive dissonance and undergraduate nursing students' knowledge of, and attitudes about, smoking

BACKGROUND

Smoking is a major cause of morbidity and mortality. Although nurses have an important role in health promotion, and are well placed to see the harmful effects of tobacco smoking, studies suggest that they smoke at much the same rate as the general population.

AIM

The aim of this paper is to report a study examining undergraduate nursing students' knowledge about the impact of smoking on health, and their attitudes towards smokers and smoking.

METHODS

The study took place in 2001, using a non-probability sample of 366 undergraduate nursing students from an Australian university. Participants completed the Smoking and Health Promotion instrument. Festinger's theory of cognitive dissonance provided an explanatory framework for the findings.

RESULTS

Most respondents who were still smoking began the habit while in high school. Students had greater generic than specialized knowledge about the effects of smoking on health, and there was no significant difference between second and third year students' knowledge. Those who still smoked had less favourable attitudes towards smoking-related health promotion than those who had never smoked or stopped smoking. Non-smokers were more supportive of non-smokers' rights than those who continued to smoke, while those who had stopped smoking were undecided. There was minimal association between levels of knowledge and attitudes about being sensitive to smoking-related health risks.

CONCLUSION

The findings have implications for both high school education and undergraduate nursing education, and for the recruitment of students to undergraduate nursing programmes. More attention needs to be given in undergraduate nursing programmes to smoking and smoking-related illnesses, and to nurses' role in smoking health promotion.

A comparison of smoking habits among medical and nursing students

OBJECTIVE

The approach and credibility of future physicians and nurses as treatment providers for smoking- and tobacco-related diseases may be influenced by their smoking habits. We compared smoking habits among medical and nursing students, and examined whether these habits changed during the course of education for each cohort.

METHOD

Over 1,100 medical and nursing students from a university were surveyed in year 2000 using a questionnaire that included the Fagerstrom test for nicotine dependence (FTND).

RESULTS

A total of 397 medical students and 126 nursing students completed the survey. Significantly fewer medical students (3.3%) smoked compared to nursing students (13.5%). Also, significantly more nursing students were former smokers (17.8%) than medical students (9.8%). The severity of nicotine dependence, as indicated by the total FTND score as well as scores on five of the six items on the FTND, was significantly lower among medical students compared to nursing students. Smoking or quit rates did not differ across class years in both groups; however, unlike nursing students, time since quitting significantly differed across class years for medical students. Although smoking habits appear to change little during the course of education for both medical and nursing students, many smokers may have quit just prior to entering medical school but not nursing school.

CONCLUSIONS

The findings confirm the continuing decline in smoking among medical students in the United States; however, increased efforts to promote tobacco education and intervention among nursing students seem necessary. Nevertheless, both groups appear to have the potential to be credible advisors to patients and public regarding smoking cessation.

Drinking during pregnancy: attitudes and knowledge among pregnant Danish women, 1998

BACKGROUND

During the 1990s, most Western countries officially recommended that pregnant women abstain from alcohol. However, information about the potentially harmful effects of alcohol during pregnancy does not necessarily equate to understanding, and information and knowledge may not be associated with pregnant women's own attitudes toward drinking.

METHODS

From October to December 1998, we interviewed 439 Danish-speaking pregnant women who were referred for routine antenatal care at their first visit at 15 to 16 weeks of gestation. The women were interviewed about their attitudes toward and beliefs and knowledge about drinking during pregnancy. Questions were also asked about information on alcohol provided to the women.

RESULTS

Seventy-six percent of the women considered some alcohol intake during pregnancy to be acceptable, mostly on a weekly level. Binge drinking, however, was considered to be harmful by 85%. These attitudes were not associated with knowledge about the official recommendation or whether the woman had talked to her general practitioner or midwife about alcohol during pregnancy. Most of the women had received information on alcohol from the mass media or relatives, but most women believed that information about alcohol during pregnancy could best be communicated to them by health personnel. Only 21% were aware of the official recommendation from the Danish National Board of Health. One third had discussed alcohol with their general practitioner or midwife, but these women had mostly been advised that some alcohol intake was acceptable.

CONCLUSIONS

Most of the women considered some alcohol intake during pregnancy to be acceptable, mostly on a weekly level, and their attitudes were independent of their knowledge about the subject. Most of the women had not been informed about alcohol during pregnancy.

Smoking behavior, initiating and cessation factors among Japanese nurses: a cohort study

The prevalence of smoking among Japanese nurses, specially in their twenties, is higher than that among the general female population. To examine smoking behavior, smoking initiating and cessation factors, we conducted a cohort study through questionnaire survey, targeting nurses (n=1572) working at 11 hospitals located in Tokyo metropolitan area. The first survey was conducted using a confidential questionnaire on smoking, followed by a second survey conducted in the same manner on the same subjects two years later. As to smoking status after two years, 8% (95%CI=1.5%) started smoking and 6% (95%CI=1.4%) quitted resulting in a 2% increase in the prevalence of current smoking. The average nicotine dependence for nurses who were smokers in the two surveys rose from 3.9 to 4.3 (P<0.05). Smoking behavior of mother, friends, or superiors at work had a significant influence on smoking behavior of nurses. As to smoking cessation factors, the idea that women and medical workers should not smoke, and living with family each had a significant influence. Considering the fact that 6% of nurses in this study succeeded in quitting smoking within two years, it is required that anti-smoking education be conducted at medical institutions to decrease the prevalence of current smoking among the nurses in Japan.

A comparison of smoking habits, beliefs and attitudes among Tuscan student nurses in 1992 and 1999

Two-hundred-and-fifty students (aged 24+/-4 years, mean +/- SD, females were 75%) attending the first year of training in Florence Nursing School in 1991-1992 and 205 ones (aged 22+/-4 years; females 83% of the total) in the first year course of Nursing Schools of the Universities of Siena and Florence in 1998-1999 answered the same anonymous, self-administered questionnaire about their smoking habits, beliefs and attitudes. The overall response rate was 92% in 1992 and 88% in 1999. In 1992 and 1999, respectively, exsmokers were 13 and 11%, current smokers 51 and 43%. Ten percent of nurses who smoked in 1992 and 16% in 1999 were occasional smokers. The average daily number of cigarettes among respondents who smoked was lower in 1999. For both the surveys the beliefs about tobacco smoking remained generic and more often drawn from unspecific sources of information. Compared to 1992, in 1999 student nurses improved some attitudes towards smoking, such as the increased awareness that smoking cessation methods may be useful to quit and that hospital should be smoke-free. These positive attitudes did not change their smoking habits and the opinion on their ongoing smoking habits. Student nurses also did not obtain a consistently increased awareness about their role for advising subjects who smoked against smoking. We conclude that from 1992 to 1999 in Tuscany the smoking habits of first year student nurses changed little and remained high. There is a need for targeting antismoking education and for including specific training about tobacco smoking in the curricula of Italian nurse schools.

Tobacco smoking habits, beliefs, and attitudes among medical students in Tirana, Albania

BACKGROUND

Many surveys throughout the world have evaluated the smoking behaviors, beliefs, and attitudes of medical students, but no information is available from Albania.

METHOD

A cross-sectional survey in classroom settings using a self-administered questionnaire was performed at the University of Tirana during October 2000.

RESULTS

In the first and fifth years of medical school, 149 (68.5% women) and 185 (55% women) students, respectively, completed the questionnaire, with overall response rates of 82 and 92%. Tobacco smoking prevailed among males. The smoking rates among first-year medical students were 34% among men and 5% among women. Among fifth-year students, 55% of the men and 34% of the women smoked. The percentages of occasional smokers were 29 and 49%, respectively, among the first- and fifth-year students who smoked. Most medical students reported knowing the health hazards of tobacco. Most students in both groups believed that smoking should be restricted in hospitals. Slightly more than half of the students stated that they will regularly advise smokers against smoking in their future jobs.

CONCLUSION

Tobacco smoking is common among medical students in Albania. Targeted antismoking training should be mandatory for medical students in Albania.