Cigarette smoking among nurses remains a public health concern despite a recent decline in current smoking prevalence. We recruited 149 registered nurses into a no-cost, targeted, self-help smoking cessation program supplemented by a supportive worksite environmental module. The study was designed to expand understanding of nurses' smoking and to measure program effectiveness.
Follow-ups were conducted at one, six and 12 months post-intervention to assess self-reported smoking status (92% objectively validated) and predictors of cessation. Point prevalence abstinence at these time points (22.5%, 21.5% and 19.5%), continuous abstinence (12. 7%), and an ever-quit rate of 57% (i.e., quit for at least 48 hours), compare favorably to population quit rates and to rates reported for other self-help programs.
Logistic regression analyses were utilized to identify predictors of short-term cessation [time before needing a cigarette, concern regarding the health hazards of smoking, working in a critical care setting, use of targeted weight manual] and long-term cessation [dosage (inverse relationship), use of standard American Lung Association maintenance manual, working with dying patients, and M. D. s' opposition to upgrading nursing service (inverse relationship)].
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References
1.
U.S. Department of Health, Education and Welfare. Survey of Health Professionals, 1975. Washington, D.C., National Clearinghouse for Smoking and Health, DHEW Publication No. CDC 21074-552(P), 1976.
2.
BeckerD.MyersA.SacciM.WeidaS.SwankR.LevineD.PearsonT.Smoking behavior and attitudes toward smoking among hospital nurses. American Journal of Public Health, 1986; 76:1449–1451.
3.
FeldmanB.RichardE.Prevalence of nurse smokers and variables identified with successful and unsuccessful smoking cessation. Research in Nursing and Health, 1986; 9:131–138.
4.
GarfinkelL.StellmanS.Cigarette Smoking among Physicians, Dentists and Nurses. Cancer, 1986; 36:2–8.
LeatharD.Smoking among student nurses: An exploratory study into reasons underlying nurses' smoking habits. Nursing Times, 1980; 76:589–590.
7.
MorraM.KnobfM.Comparison of nurses' smoking habits: The 1975 DHEW Survey and Connecticut Nurses, 1981. Public Health Report, 1983; 98:553–557.
8.
MyersA.RosnerB.AbbyH.WilletW.StampferM.BainC.LipnickR.HennekensC.SpeizerF.Smoking behavior among participants in the Nurses' Health Study. American Journal of Public Health, 1987; 77:628–630.
9.
TagliacozzoR.VaughnS.Stress and smoking in hospital nurses. American Journal of Public Health, 1982; 72:441–448.
10.
U.S. Department of Health and Human Services. The Health Consequences of Smoking: Cancer and Chronic Lung Disease in the Workplace. A Report of the Surgeon General. U.S. Department of Health and Human Services, Public Health Service, Office of the Assistant Secretary for Health. Office on Smoking and Health, Rockville, Maryland. DHHS Publication No. (PHS) 85-5027, 1985.
11.
CraneL.National Health Interview Survey, 1985. Public Use Tapes, National Center for Health Statistics. Unpublished Data, 1987.
12.
BelangerR.HennekinsC.RosnerB.SpeizerF.The nurses' health study. American Journal of Nursing, 1978; 78:1039–1040.
13.
ElkindA.Nurses, smoking and cancer prevention. International Journal of Health Education, 1979; 22:92–100.
14.
EnstromJ.Trends in mortality among California physicians after giving up smoking: 1950–79. British Medical Journal, 1983; 286:1101–1105.
15.
EyresS.Public Health Nursing Section: Report of the 1972 APHA smoking survey. American Journal of Public Health, 1973; 63:846–852.
16.
DickenC.BrysonR.Psychology in action: The smoking of psychology. American Psychologist, 1978; 33:504–507.
17.
StellmanS.SiellmanJ.Women's Occupations, Smoking, and Cancer and Other Diseases. Cancer, 1981; 31:29–43.
18.
HillierS.Nurses' smoking habits. Postgraduate Medical Journal, 1973; 49:693–694.
19.
SmallW.TuckerL.The smoking habits of hospital nurses. Nursing Times, 1978; 74:1878.
20.
Royal College of Physicians. Smoking or Health. Pitman Medical Publishing Company, London, 1977.
KandelD.YamaguchiK.Developmental patterns of use of legal, illegal, and medically prescribed psychotropic drugs from adolescence to young adulthood. Etiology of Abuse: Implications for Prevention. JonesC.BattjesR., U.S. Department of Health and Human Services, Public Health Service, National Institute on Drug Abuse Research Monograph 56, 1985. Pp. 193–235.
23.
DaltonJ.SwensonI.Nurses, the professionals who can't quit. American Journal of Nursing, 1983; 83:1149–1151.
24.
HawkinsL.WhiteM.MorrisL.Smoking, stress and nurses. Nursing Mirror, 1982; 155:18–22.
25.
KirkhyR.BashkawiE.DrewC.FoenanderG.Smoking in nurses. Medical Journal of Australia, 1976; 2:864–865.
26.
LiddellI.DewarH.Smoking amongst nurses in Newcastle in 1982. Public Health, 1983; 97:246–256.
27.
U.S. Bureau of Labor Statistics: Employment Earnings, U.S. Bureau of the Census Statistical Abstract of the United States, 1987, 10th Edition, Washington, D.C., 1986.
28.
FisherE.Jr.GritzE.JohnsonC.Cessation of smoking. The Health Consequences of Smoking: Cancer. A Report of the Surgeon General. US Department of Health and Human Services, Public Health Service, Office on Smoking and Health, Rockville, Maryland. DHHS Publication No. (PHS) 82-50179, 1982. Pp. 255–304.
29.
OrleansC.Understanding and promoting smoking cessation: Overview and guidelines for physician intervention. Annual Review of Medicine, 1985; 36:51–61.
30.
U.S. Department of Health and Human Services. The Health Consequences of Smoking: Chronic Obstructive Lung Disease. A Report of the Surgeon General. U.S. Department of Health and Human Services. Public Health Service, Office of the Assistant Secretary for Health, Office on Smoking and Health. Rockville, Maryland. DHHS Publication No. (PHS) 84-50204, 1984.
31.
GritzE.CarrC.MarcusA.Unaided smoking cessation: Great American Smokeout and New Year's Day Quitters. Psychosocial Oncology (In press).
32.
JacobP.IIIWilsonM.BenowitzN.Improved gas chromatographic method for the determination of nicotine and cotinine in biologic fluids. Journal of Chromatography, 1981; 222:61–70.
33.
National Center for Health Statistics: Health, United States, 1985. Pub. No. (PHS) 85-1232. Public Health Service. U.S. Government Printing Office, Washington, D.C., 1985.
34.
FagerstromK.Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addictive Behavior, 1978; 3:235–241.
35.
FagerstromK.A comparison of psychological and pharmacological treatment in smoking cessation. Journal of Behavioral Medicine, 1982; 5:343–351.
36.
DavisK.JacksonK.KronenfeldJ.Intent to participate in worksite health promotion activities: A model of risk factors and psychosocial variables. Health Education Quarterly, 1984; 11:361–377.
37.
AbramsD.ElderJ.CarletonR.LasaterT.ArtzL.Social learning principles for organizational health promotion: An integrated approach. Behavioral Medicine in Industry. CataldoM.CoatesT. (Eds.). John Wiley, New York, 1986. Pp. 28–51.
38.
GlasgowR.KlesgesR.Smoking intervention programs in the workplace. The Health Consequences of Smoking: Cancer and Chronic Lung Disease in the Workplace. A Report of the Surgeon General. U.S. Department of Health and Human Services, Assistant Secretary for Health, Office on Smoking and Health. Rockville, Maryland. DHHS Publication No. (PHS) 85-5027, 1985.
39.
DavisA.FaustR.OrdentlichM.Self-help smoking cessation and maintenance programs: A comparative study with 12-month follow-up by the American Lung Association. American Journal of Public Health, 1984; 74:1212–1217.
40.
HarveyA.The effects of personal and family history of smoking-related diseases on smoking cessation among registered nurses. Unpublished thesis. The Johns Hopkins University, Baltimore, Maryland, 1984.
41.
SorensonG.PechacekT.Occupational and sex differences in smoking and smoking cessation. Journal of Occupational Medicine, 1986; 28:360–364.
42.
U.S. Department of Health and Human Services. The Health Consequences of Smoking for Women. A Report of the Surgeon General. U.S. Department of Health and Human Services. Public Health Service, Office of the Assistant Secretary for Health, Office on Smoking and Health, Rockville, Maryland, 1980.
43.
GordonN.ClearyP.Smoking cessation in a national probability sample cohort 1979–1980: Health attitudes, practices and smoking behavior associated with quit attempts and behavior change at one year. John F. Kennedy School of Government, Institute for the Study of Smoking Behavior and Policy Discussion Paper Series (10). Harvard University, 1986.
44.
GritzE.BermanB.MarcusA.ReadL.KanimL.ReederS.Ethnic variations in the prevalence of smoking among Registered Nurses. Cancer Nursing (In press).
45.
U.S. Department of Health and Human Services. The Health Consequences of Smoking: Cardiovascular Disease. A Report of the Surgeon General. U.S. Department of Health and Human Services. Public Health Service, Office of the Assistant Secretary for Health, Office on Smoking and Health, Rockville, Maryland. DHHS Publication No. (PHS) 84-50204, 1983.
46.
BeckerM.MaimanL.Strategies for enhancing patient compliance. Journal of Community Health, 1980; 7:113–135.
47.
GreenD.Nurses are kicking the habit. American Journal of Nursing, 1970; 70:1936–1938.
48.
GritzE.BiermanK.Psychosocial and behavioral aspects of smoking in women: Maintenance and cessation. The Health Consequences of Smoking for Women. A Report of the Surgeon General. U.S. Department of Health, Education and Welfare. Public Health Services, Office of the Assistant Secretary for Health, Rockville, Maryland, 1980. Pp. 292–359.
49.
DaltonJ.SwensonI.Nurses and smoking: Role modeling and counseling behaviors. Oncology Nursing Forum1986; 13:45–48.
50.
GoldsteinA.HellierA.FitzgeraldS.StegallT.FischerP.Hospital nurse counseling of patients who smoke. American Journal of Public Health, 1987; 77:1333–1341.
51.
LichtensteinE.GlasgowR.AbramsD.Social support in smoking cessation: In search of effective interventions. Behavioral Therapy, 1986; 17:607–619.
52.
CoppitelliH.OrleansC.Partner support and other determinants of smoking cessation maintenance among women. Journal of Consulting and Clinical Psychology, 1985; 33:455–460.
53.
HillR.ChesneyM.Partial success in behavioral couples treatment of chronic smoking: A case report. Family Systems Medicine, 1985; 3:301–307.
54.
WestmanM.EdenD.ShiromA.Job stress, cigarette smoking and cessation: The conditioning effects of peer support. Social Science and Medicine, 1985; 20:637–644.
