Nurses Enrolled in a Stop Smoking Program: The Role of Occupational Stress

Work environment and smoking cessation over a five-year period

Aims: The authors set out to estimate effects of occupational factors on smoking cessation among Danish employees. Methods: Data from 3,606 observations of smokers gathered from the Danish National Work Environment Cohort Study in 1990, 1995, and 2000 were analysed by logistic regression. The model comprised background variables, smoking variables, and measures of psychosocial and other aspects of the work environment. Results: Statistically significant odds ratios (OR) for cessation were found for medium versus no exposure to noise (OR 0.71, 95% CI 0.54 - 0.93), for high versus low physical workload (OR 0.49, 95% CI 0.47 - 0.73), for high versus low psychological demands (OR 1.42, 95% CI 1.12 - 1.80), and for medium versus low levels of responsibility at work (OR 1.31, 95% CI 1.03 - 1.65). Conclusion: The probability of smoking cessation differs between people with different exposures to certain work environmental factors.

The relationship between workplace, job stress and nurses' tobacco use: a review of the literature

The aim of this study was to provide a summary of the existing published knowledge on the possible relationship between the workplace as a stressor factor and nurses’ tobacco use. A systematic review of the literature from 1995 to 2009, using the MEDLINE database took place. Studies, that referred to nurses’ smoking habit exclusively or as a part of the study, were included in the review. 491 studies were retrieved and their titles/abstracts were examined systematically. Twenty one studies were retrieved for further consideration by a comprehensive literature review. Ten studies fulfilled the eligibility criteria and they were examined further. There is a conflict on the possible relationship between workplace as a stressor factor and nurses’ smoking habits, because there is no evidence on if the nurses’ work environment causes smoking initiation.

A systematic review of the impact of work environment on smoking cessation, relapse and amount smoked

BACKGROUND

Smoking is an important issue for the majority of the world's working population. It is important to explore in which ways the workplace might contribute to changes in smoking status and smoking behavior. The present article provides a systematic review and quality assessment of studies that have addressed the impact of factors in the work environment on smoking behavior.

METHODS

An evaluation of the methodological quality of 22 prospective studies was based on 14 explicit criteria, which included features of study design, statistical analysis, sampling issues and measurement. The level of scientific evidence was evaluated for each study.

RESULTS

There was strong evidence for an effect of the work environment on the amount smoked, but insufficient or mixed evidence regarding cessation and relapse. Summarizing the results, high job demands were associated with higher amount smoked and with increased likelihood of cessation. Resources at work and social support were positively associated with cessation and negatively associated with relapse and the amount smoked.

CONCLUSIONS

The results supported the overall hypothesis that the work environment influences aspects of smoking behavior. Recommendations are made for more intervention studies where changes in work environment are carried out in combination with health promotion interventions.

Work factors and smoking cessation in nurses' aides: a prospective cohort study

BACKGROUND

The prevalence of smoking in nursing personnel remains high. The aim of this study was to identify work factors that predict smoking cessation among nurses' aides.

METHODS

Of 2720 randomly selected, Norwegian nurses' aides, who were smoking at least one cigarette per day when they completed a questionnaire in 1999, 2275 (83.6 %) completed a second questionnaire 15 months later. A wide spectrum of work factors were assessed at baseline. Respondents who reported smoking 0 cigarettes per day at follow-up were considered having stopped smoking. The odds ratios and 95 % confidence intervals of stopping smoking were derived from logistic regression models.

RESULTS

Compared with working 1-9 hours per week, working 19-36 hours per week (odds ratio (OR) = 0.35; 95 % confidence interval (CI) = 0.13 - 0.91), and working more than 36 hours per week (i.e. more than full-time job) (OR = 0.27; CI = 0.09 - 0.78) were associated with reduced odds of smoking cessation, after adjustments for daily consumption of cigarettes at baseline, age, gender, marital status, and having preschool children. Adjusting also for chronic health problems gave similar results.

CONCLUSION

There seems to be a negative association between hours of work per week and the odds of smoking cessation in nurses' aides. It is important that health institutions offer workplace-based services with documented effects on nicotine dependence, such as smoking cessation courses, so that healthcare workers who want to stop smoking, especially those with long working hours, do not have to travel to the programme or to dedicate their leisure time to it.

Nurses, smoking, and the workplace

The purpose of this study was to examine attitudes and experiences of nurses regarding smoking and smoking cessation in the workplace. Eight focus groups were conducted with current or former smokers (n = 60). A questionnaire provided information about smoking history. Content analysis revealed six themes: taking breaks, stress and smoking, social support from colleagues, hiding smoking from patients and their families, impact of workplace smoking restrictions, and challenges to smoking cessation in the workplace. Nurses who smoke were perceived as taking more breaks and spending less time with patients than those who do not smoke. These findings document the impact of smoking among nurses in the workplace. Strategies are needed to support smoking cessation efforts of nurses as an important occupational health issue.

The effect of work environment and heavy smoking on the social inequalities in smoking cessation

OBJECTIVES

To investigate social differences with regard to smoking cessation in Denmark.

METHODS

Social differences in smoking cessation were estimated from 3606 smokers from the Danish National Work Environment Cohort Study in 1990, 1995 and 2000. The differences were investigated using heavy smoking and four work environment factors as explanatory variables.

RESULTS

The odds ratio for cessation was more than twice as high in social class I compared with social class V. When heavy smoking was controlled, this explained 28% of social differences, the work-environment factors alone explained 36% of social differences, and together the factors explained 55% of social differences.

CONCLUSIONS

A large proportion of the social differences in smoking cessation could be explained by differences in work-environment exposures and smoking intensity.

Cigarette smoking in veteran women: the impact of job strain

To evaluate the health effects of role overload, the relationship between multiple role (i.e., worker, spouse, caretaker) strain and current cigarette smoking was examined. A cross-sectional survey of women veterans, aged 36-85 years, was performed measuring home and job strain and health behaviors. Of the 275 women who rated both their work and home strains, 25% (n = 69) currently smoke cigarettes. Higher work strain, but not higher home strain, was associated with smoking adjusting for age, education, income, weight, and marital status. A stressful work environment may trigger persistent smoking and should be addressed during smoking cessation counseling.