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Zeng LN, Zong QQ, Zhang JW, An FR, Xiang YF, Ng CH, Ungvari GS, Yang FY, Yan H, Chen LG, Hu X, Xiang YT. Prevalence of smoking in nursing students worldwide: A meta-analysis of observational studies. NURSE EDUCATION TODAY 2020; 84:104205. [PMID: 31734641 DOI: 10.1016/j.nedt.2019.104205] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 06/18/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
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.
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Affiliation(s)
- Liang-Nan Zeng
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau; Center for Cognition and Brain Sciences, University of Macau, Macau; Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University; Neurosurgery Clinical Medical Research Center of Sichuan Province, Academician (Expert) Workstation of Sichuan Province; Sichuan, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Ji-Wen Zhang
- School of Nursing, Capital Medical University, Beijing, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | | | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Gabor S Ungvari
- The University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Fang-Yu Yang
- School of Nursing, Capital Medical University, Beijing, China
| | - Hong Yan
- School of Public Health, Wuhan University, Wuhan, China
| | - Li-Gang Chen
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University; Neurosurgery Clinical Medical Research Center of Sichuan Province, Academician (Expert) Workstation of Sichuan Province; Sichuan, China.
| | - Xiaobin Hu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau; Center for Cognition and Brain Sciences, University of Macau, Macau.
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Heath J, Crowell NA. Factors influencing intentions to integrate tobacco education among advanced practice nursing faculty. J Prof Nurs 2007; 23:189-200. [PMID: 17675113 DOI: 10.1016/j.profnurs.2007.01.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Indexed: 10/23/2022]
Abstract
We report on the findings of a national survey that examined factors that influence faculty's intentions to integrate tobacco education in their advanced practice nursing curricula. The addiction component of tobacco use is taking its toll on the health of 48 million smokers in the United States. Several national health authorities recommend and/or mandate that tobacco prevention and tobacco cessation be addressed at every point of entry in the health care delivery system. However, there is increasing evidence that health care providers may not be adequately prepared to meet national goals and/or standards. One hundred sixty-one advanced practice nursing faculty in the United States completed an 88-item survey regarding external factors (e.g., personal history of tobacco use, clinical practice, and current tobacco topics taught) and components of the Theory of Reasoned Action model (including perceived self-efficacy, behavioral beliefs, subjective norms, and control beliefs related to tobacco education). Descriptive statistics, chi(2) analysis, Pearson correlation, and linear regression were used to analyze the data. The findings revealed that sex (chi(2) = 7.949, P = .024), level of education (chi(2) = 26.853, P = .0005), years of academic teaching (chi(2) = 19.418, P = .013), and combined clinical and course responsibility (chi(2) = 10.430, P = .0236) were significant external (demographic) factors and that behavioral beliefs (attitude about tobacco education) demonstrated the strongest relationship with intention scores (r = 0.876, P < .0005). Overall, 62.7% of nurse practitioners reported high scores (>or=5, on a scale of 1-7) for intentions to integrate tobacco education, as compared with 37.5% of nurse midwives, 30.3% of clinical nurse specialists, and 8.7% of nurse anesthetists. This study adds to the growing body of evidence that nursing curricular gaps with tobacco education exist and that national efforts are needed to ensure that widespread changes occur to help reduce the morbidity and mortality related to tobacco use.
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Affiliation(s)
- Janie Heath
- Acute Care Nurse Practitioner and Critical Care Clinical Nurse Specialist Program, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA.
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Abstract
Tobacco use is a major health risk that requires a comprehensive response by healthcare professionals. Nurse educators can contribute to the reduction of tobacco use by educating nursing students about tobacco use and smoking cessation strategies. The authors examine the breadth and depth of tobacco cessation content in Kansas registered nursing programs providing insight into the content and resources needed to teach nursing faculty and students how to assist individuals in tobacco use cessation.
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McKenna H, Slater P, McCance T, Bunting B, Spiers A, McElwee G. The role of stress, peer influence and education levels on the smoking behaviour of nurses. Int J Nurs Stud 2003; 40:359-66. [PMID: 12667512 DOI: 10.1016/s0020-7489(02)00099-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Smoking kills yet a substantial number of qualified nurses continue to smoke. Stress, peer influence and education levels have been cited as influencing prevalence levels among nurses. A self-completed questionnaire was used to survey qualified nurses' perceptions of smoking prevalence, attitudes, and reasons for smoking. The respondents were composed of a random sample (n=1074) of qualified nurses employed in Northern Ireland. Results show that 25.8% of the sample smoked. Factors influencing smoking behaviour and reasons for continuing smoking are explored. This paper discusses the implications of these findings for nursing and nurses' health promotion activities.
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Affiliation(s)
- Hugh McKenna
- School of Life Sciences, University of Ulster, Jordanstown, Co Antrim BT37 0QB, UK.
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Abstract
As the most numerous health care providers, nurses could reduce tobacco-related morbidity and mortality. A cross-sectional survey of 476 junior and senior students at 12 schools of nursing in the New York metropolitan area was conducted, to determine nurse knowledge of tobacco control, their attitudes, beliefs, and practices. Overall, 76% of all nursing students reported that they practiced tobacco control. Current smokers were less likely to participate in tobacco control with targets ranging from the nurse herself to the community than either never or ex-smokers. Nurses were more likely to engage in tobacco control among individual, family, or group clients than to advocate for changes in the community. Student nurses who were African American or Hispanic, had never smoked or were ex-smokers, those who had better knowledge of cessation approaches, and those who tended to have more confidence in their cessation counseling skills were more likely to engage in multi-target tobacco control than other similar nurses. Tailored interventions that emphasize discrete counseling skills are suggested.
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Affiliation(s)
- S S Gorin
- Divisions of Sociomedical Sciences and Epidemiology, Mailman School of Public Health Columbia University, New York, NY 10032, USA.
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Ohida T, Kamal AA, Takemura S, Sone T, Minowa M, Nozaki S. Smoking behavior and related factors among Japanese nursing students: a cohort study. Prev Med 2001; 32:341-7. [PMID: 11304095 DOI: 10.1006/pmed.2001.0828] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although there have been several surveys on smoking behavior among Japanese nursing students, most have been cross-sectional studies. No longitudinal studies, such as a prospective cohort study, have ever been carried out. We therefore conducted a cohort study on, and analyzed smoking behavior and related factors among, Japanese nursing students. METHODS A survey on smoking behavior using a confidential questionnaire was conducted on nursing students at two vocational schools of nursing and two nursing colleges/universities located in the Tokyo metropolitan area. Another survey was subsequently conducted in the same manner among the same subjects 1 year later. The surveys were conducted between 1997 and 1999. RESULTS Over the 1-year period, the prevalence of smoking among nursing students increased by 10% for students at the vocational schools of nursing (n = 224) and by 3% for students at the nursing colleges/universities (n = 222). The average score for nicotine dependence for students who were daily smokers at both time points rose from 3.6 to 4.4 (P < 0.05). Two factors found to significantly predict smoking behavior were having friends who smoke and living alone. CONCLUSION Smoking prevalence is increasing among Japanese nursing students. Smoking prevention and cessation interventions should be instituted in all nursing training programs.
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Affiliation(s)
- T Ohida
- Department of Public Health Administration, National Institute of Public Health, Tokyo, Japan.
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Abstract
The smoking behaviour of nurses has been widely debated in the context of their professional role and responsibilities. There has been much speculation about why nurses smoke and possible explanations include a stressful nursing environment, peer pressure and socio economic status and education. This paper provides an overview of the literature which offers insights into the reasons why nurses smoke and compares the findings from this literature with those studies examining the smoking behaviour of women in general and young women in particular. This review reveals that many students take up smoking before commencing their training and the factors which influence nurses smoking are similar to those that influence similar groups of females in the general population.
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Affiliation(s)
- K Rowe
- The School of Nursing and Midwifery, The Queen's University of Belfast, University Road, Belfast, Northern Ireland, UK
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Hope A, Kelleher CC, O'Connor M. Lifestyle practices and the health promoting environment of hospital nurses. J Adv Nurs 1998; 28:438-47. [PMID: 9725743 DOI: 10.1046/j.1365-2648.1998.00791.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.
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Affiliation(s)
- A Hope
- Centre for Health Promotion Studies, National University of Ireland, Galway, Republic of Ireland
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Abstract
Senior nursing students (N = 505) attending 13 schools in the NY metropolitan area were administered a questionnaire to assess their beliefs about the importance of health promotion behaviors to the average person. Respondents rated 23 health promotion practices on a Likert scale. The five most important items concerned: knowledge of drug contents and their side effects; the elimination of cigarette and cigar smoking; eating a balanced diet; and using a seat belt. The least important item concerned having an annual exercise test. These results were similar to those found for other health care providers, including physicians, dietitians, and pharmacists. Further, the results were similar to those found in an earlier survey of student nurses. Nurses' attitudes and beliefs seem supportive of health promotion and disease prevention. These attitudes also seem associated with the nurse's role as health promoter. Positive nurse attitudes/beliefs toward health promotion are posited as precursors to the alteration of patient behaviors, although further exploration in this area is needed.
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Affiliation(s)
- S S Gorin
- School of Social Work, Adelphi University, Garden City, NY 11530
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Abstract
An analysis of smoking behavior among nurses shows unacceptably high levels of smoking, despite some evidence of a downward trend. In this article, the nature of tobacco dependence is examined, and an extensive review of demographic and causative factors associated with the smoking behavior of nurses is presented. The impact of smoking on the practice of nurses, particularly related to their ability to serve as health educators and role models, is critically examined. Areas for potential research and inquiry, along with some overall strategies for intervention, are identified.
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Affiliation(s)
- C A Padula
- College of Nursing, University of Rhode Island, Kingston 02881
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Adriaanse H, Van Reek J, Zandbelt L, Evers G. Nurses' smoking worldwide. A review of 73 surveys on nurses' tobacco consumption in 21 countries in the period 1959-1988. Int J Nurs Stud 1991; 28:361-75. [PMID: 1761380 DOI: 10.1016/0020-7489(91)90062-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Nurses are the largest professional group in health care. Nurses' smoking is not only important to their personal health, but also to the public's health. Analysis of smoking prevalences found among nurses in 21 countries in the period 1959-1988 shows that considerable numbers of both female and male nurses are smokers. More often than not there are found as many smokers among nurses as among the general population, sometimes even more. Only in Canada and Finland female nurses smoked clearly less than the population at large. Nurses' smoking prevalences decreased slowly in industrialized countries. An exemplary role is recognized by many nurses; more so by non-smoking nurses than by their smoking colleagues. Factors influencing nurses' smoking are professional socialization, duality of roles, workstress, discrepant expectancies about nurses' role and lack of social support. Theoretical explanations for nurses smoking by means of the theories of strain, of selection, of social control and of professional subculture are discussed. Future research should be internationally coordinated and aimed at comparability within a cultural and organizational context.
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Affiliation(s)
- H Adriaanse
- Department of Health Education, University of Limburg, Maastricht, The Netherlands
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Soeken KL, Bausell RB, Winklestein M, Carson VJ. Preventive behaviour: attitudes and compliance of nursing students. J Adv Nurs 1989; 14:1026-33. [PMID: 2613955 DOI: 10.1111/j.1365-2648.1989.tb01513.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
As a professional, the nurse is called upon to serve as a role model for positive health behaviours. Because the practise of these behaviours may effect one's effectiveness as a role model, it is important to determine whether nurses lead a so-called preventive lifestyle and to identify what factors are predictive of compliance. Previous researchers have tended to examine individual behaviours. In this study, a prevention index was used to examine an overall preventive lifestyle. For a sample of senior year nursing students, the preventive behaviours were considered to be important. However, when compared to a national sample of females in the same age range, nursing students were found to be significantly less compliant for 12 of 19 behaviours and more compliant for only three behaviours. Both the desire to practise preventive behaviours and the perceived difficulty in doing so were the factors predictive of the level of compliance. Additional study is needed to determine how these factors can be mediated.
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Affiliation(s)
- K L Soeken
- Center for Nursing and Health Services Research, University of Maryland, School of Nursing, Baltimore 21201
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Elkind AK. Smoking and the female professions: pre-occupational influences on the behaviour of recruits to nursing and teaching. Soc Sci Med 1988; 26:243-51. [PMID: 3347850 DOI: 10.1016/0277-9536(88)90245-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A questionnaire and interview study of female recruits to nursing and teaching showed that occupational differences in the prevalence of smoking are already established at entry to training. The social characteristics of the smokers in the sample corresponded to those of women smokers generally. Differences in education and social origin contributed to occupational variations in behaviour. The influence of sibling behaviour and parental opinion operated differently within the two occupational groups. The psychological attributes of individuals attracted to a particular profession may also contribute to occupational patterns, specifically risk-taking and a concern for personal freedom.
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Affiliation(s)
- A K Elkind
- Department of Epidemiology & Social Oncology, Christie Hospital & Holt Radium Institute, Withington, Manchester, England
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