Abstract
Stress and cigarette smoking have been linked in many studies. An assessment was also done to measure how the variables of finances, workload and dependency add to stress, anxiety, depression and addiction among the respondents. This study puts weight to the fact that smoking is prevalent among healthcare workers around the world. In many parts of the world, nurses are found to be smokers, and even though there are campaigns to influence smokers, many nurses continue smoking for several reasons, but one given factor was the role that stress plays in causing people to reach out for a cigarette to calm themselves down. Psychological factors play a vital role towards smoking, as observed through the study.
Keywords: Smoking cessation, nurses, psychological factors
Introduction
The world over, cigarette smoking is already known to be harmful to the body . The effects of smoking are detrimental to the overall body’s health, where every organ is exposed to harm . Although smoking as a fashionable trend is more common in perception to be consumed by the general public irrespective of profession, except it is frowned upon to witness a person belonging to the healthcare sector to engage in smoking. Hospitals in the US have issued a ban on people working for them to smoke on the hospital premises, extending this prohibition to other healthcare facilities as well from smoking within a certain distance .
Apparently smoking as a habit is not limited to non-healthcare workers. In the case of Serbia, healthcare workers were surveyed for their smoking habits, of which most of these healthcare workers were nurses . This similarity was found in Ireland where nurses, albeit relatively low in proportions as compared to Serbia were also smokers . Likewise, studies conducted in various other countries, such as Spain , Germany , Ecuador and Poland bring weight to the fact that smoking is prevalent among healthcare workers around the world.
Smoking cessation and government imposed bans on smoking have certainly influenced smokers to quit smoking . The additional benefits of having smoke free areas are that second hand smokers as well as smokers are gradually decreasing in numbers. Public welfare entities such as the American Non-smokers’ Rights Foundation endorse nursing homes and other healthcare facilities in the US to be completely smoking free.
However, the imposition and enforcement of smoking bans and practices leading towards cessation does not factor in a vital component of smoking, which is an influential habit of peers. While smoking is commonly portrayed to be a male centric habit, linked to psychological and sociological stereotypes of male chauvinism . In reality, smoking among females is quite prevalent as well . As noted in various countries, female nurses are found to be smokers, and even though there are campaigns to influence smokers, especially females to quit smoking. The fact that it was reported that female nurses are smokers, gives way to the idea that their patients would most definitely be affected as second hand smokers; the hazards of being exposed to a smoker. The overall takeaway from this is that nurses who smoke are not limited to one gender: it influences both genders.
The consideration put forth here that needs to be determined is how influential stress is when it comes to causing people to smoke cigarettes. In some cases, the fact that a peer nurse is smoking to ease stress could cause a nurse who had not previously smoked to start smoking as a source of stress relief. This study would therefore be able to find out the psychological and sociological aspects, such as stress, peer influence, work related anxiety and other aspects.
Aim of Investigation
This study aims to indulge in the investigation from the perspective of psychology and sociology to identify the factors that affect the smoking habits of female nurses as influenced by their male peers. The study is objectively defined as follows:
Hypotheses
This research is directed by the hypotheses as presented in table 1, which establishes to validate by either proving or disapproving the theme of the study. The hypotheses stated here were built upon the research findings presented by Pesut, et al. .
Method
In order to investigate the aspects of this study the collection was data was instrumented by means of a questionnaire. This questionnaire (see Appendix 1) would survey nurses concerning their smoking habits and seek to ascertain the situations around them. The twelve questions in total were designed to collect and establish primary data for this study. The demographic criteria for selecting the nurses was based on existing research by O’Donovan & Geraldine , Pesut, et al. , and White (2015) with regard to identifying relevant populations.
The sampling criteria for this study is based on the sampling formula: n=z2*s2e2. On the basis of this formula, where z is the significance level, s is the standard deviation of the sample’s variables and e is the standard error, the sample size n was calculated to be 200.
The twelve questions are designed to ascertain the hypotheses of this study. The first 4 questions are related to the identity of the respondent. Questions 5 to 9 seek to describe and ascertain the smoking habits of the respondent. These questions are constructed with the variables of smoking frequency and peer influence, as studied by Faucher . Finally to assess how the variables of finances, workload and dependency adds to stress, anxiety, depression and addiction among the respondents, questions 10 to 12 are designed around it.
The results of these questions are statistically evaluated through graphical representation (see Appendix 2). These are verily depicting proportions and hard numbers with regards to the statistical data of the respondents. Considering that the survey was conducted over the internet on Facebook and medical information websites relevant to nursing, the respondents were assured anonymity.
Beyond just raw numbers, the data was analysed through spearman’s rho calculator to measure the strengths and the relevance of variables needed for reaching the necessary deductions. The analysis was performed in comparison as follows:
How many nurses saw nurses smoking and how many shared a cigarette with them;
How many nurses smoked and the last time they consumed a cigarette;
Financial standing and smoking frequency of nurses;
How many nurses smoked and their work load.
Result
Results show that 35.39% of nurses are influenced to share cigarettes with their peers. Moreover, from the respondents 53.93% were nurses who smoked. Although work load and financial standing by those who considered it manageable and satisfactory respectively, were found to be the highest among smokers. Hence, the hypothesis that nurses who smoke influence other nurses towards smoking is not proven. Nevertheless, other factors such as workload and financial standing have been accepted as the leading factors found prevalent among smokers.
Discussion
The success rate of the respondents was 89% of the determined sample size, which is a suitably good turnout. The sample size contained enough coverage in building the understanding towards demographic diversity in the research.
The findings are staggering with two respects. First those psychological factors do play a vital role towards smoking, as observed through the data. Aspects such as dependents, work load and low financial standing increase a stress and anxiety level, which has been verified by other studies. This was similarly verified in this research as well. The number of respondents who answered that they quit smoking was relatively low as compared to those who responded that they never smoked. So perhaps it is worthwhile to investigate and research about ways that contribute towards smoking cessation amongst smokers.
The psychological implications affecting smoking habits are very real. Perhaps more needs to be done concerning policy making by governments and healthcare institutions to ease the stress and anxiety among their employees in order to curb smoking habits.
Strengths and Limitations and Improvements
Given how existing research was conducted already with regards to smoking by healthcare members in healthcare facilities, as well as research over smoking habits among women, it proved provident to make use of such research as guiding frameworks. Most importantly, this strengthened the credibility of this study by paving way for a method to expand coverage. Existing data and findings were limited to specific countries, which add to the benefit and fruitfulness of undertaking this study.
Correspondingly, additional study concerning how effective are policies on nurses, which are enforcing a ban on smoking and these policies could be co-related with factors that influence smoking. A comparison of the two influences should be studied. Such a study would further contribute towards extending the insight we have about the subject matter. This would benefit other researchers as well as policy makers towards designing and administering policies which are more effective in curbing the influence of smoking. Every improvement towards these areas would only lead to improvement of the healthcare sector.
Conclusion
There are a sizable percentage of nurses who are found to be smokers in the survey. The number of non-smokers is nearly in equal numbers. It was verified that factors such as workload, financial standing and dependents to take care of have a psychological effect on people. This undeniably leads to smoking habits and most frequent consumption among them.
References
American NonSmokers' Rights Foundation. (2016, January 1). 100% Smokefree Nursing Homes. Berkeley: Hospitals & Healthcare Facilities. Retrieved March 12, 2016, from http://www.no-smoke.org/goingsmokefree.php?id=449
Bailey, B. A., McGrady, L., McCook, J. G., & Greenwell, A. (2013). Educating Nursing Students on Issues Related to Smoking during Pregnancy to Improve Regional Intervention Efforts. Journal of Obstetric, Gynecologic & Neonatal Nursing, 42(Supplement 1), S77-S78.
Carrión, V. F., Hernández, L. J., & Plaza, V. P. (1998). Smoking in health care workers. Identification of related factors. Archivos de bronconeumologiá, 34(8), 379-383.
Centres for Disease Control and Prevention. (n.d.). Health Effects of Cigarette Smoking. Retrieved March 12, 2016, from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm
Faucher, M. A. (2003). Factors That Influence Smoking in Adolescent Girls. Journal of Midwifery & Women's Health, 48(3).
Gamarel, K. E., Kahler, C. W., Lee, J. H., Reisner, S. L., Mereish, E. H., Matthews, A. K., et al. (2016). Sexual orientation disparities in smoking vary by sex and household smoking among US adults: Findings from the 2003–2012 National Health and Nutrition Examination Surveys. Preventive Medicine, 82(January), 1-6.
Gürkan, S., Atilgan, Y., & Sen, E. (2008). Smoking Habits of the Personnel Employed in Our Hospital and the Factors Affecting the Same. Turk Toraks Dergisi, 9(4), 160-166.
Health Media Ventures. (2016). National Smoking Bans Help Everyone, Especially Nonsmokers: Study. Retrieved March 12, 2016, from http://news.health.com/2016/02/10/national-smoking-bans-help-everyone-especially-nonsmokers-study/
Jansink, R., Braspenning, J., van der Weijden, T., Elwyn, G., & Grol, R. (2010). Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis. BMC Family Practice, 11(41).
Kennedy, M. (2014). Cigarette smoking costs weigh heavily on the healthcare system. Retrieved March 12, 2016, from http://www.reuters.com/article/us-healthcare-costs-smoking-idUSKBN0JX2BE20141219
O'Donovan, G. (2009). Smoking prevalence among qualified nurses in the Republic of Ireland and their role in smoking cessation. International Nursing Review, 56(2), 230-236.
Osuchowski, F., Penar-Zadarko, B., Bukala-Siedlecka, I., & Binkowska-Bury, M. (2009). The opinions of employees about smoking in the workplace. Przeglad Lekarski, 66(10), 801-804.
Partnership for a Tobacco-Free Maine. (n.d.). Gender Differences and Tobacco. Retrieved March 12, 2016, from http://www.tobaccofreemaine.org/channels/providers/gender_differences.php
Pesut, D., Milovanovic, B., Bulajic, M., & Bozic, D. (2010). Health care workers smoke as well--who, how much and why? Pneumologia, 59(1), 19-22.
Registered Nurses' Association of Ontario. (n.d.). Types of Nursing - Which Will You Choose? Retrieved March 13, 2016, from http://careersinnursing.ca/new-nursing-and-students/career-options/types-nursing
Sánchez, P., & Lisanti, N. (2003). The prevalence of and attitudes toward smoking among physicians in Azuay, Ecuador. Revista Panamericana de Salud Pública, 14(1), 25-30.
Schulz, M., Töpper, M., & Behrens, J. (2004). Smoking habits of employees and patients in the psychiatric department of a general hospital. Gesundheitswesen , 66(2), 107-113.
Ussher, M., Kakar, G., Hajek, P., & West, R. (2016). Dependence andmotivation to stop smoking as predictors of success of a quit attempt among smokers seeking help to quit. Addictive Behaviors, 53(February), 175-180.
White, J. (2015). Hospitals ban workers from smoking. Retrieved March 12, 2016, from http://www.healthcarebusinesstech.com/hospitals-ban-smoking/
Appendix
Appendix 1 – Data Collection Instrument
Serial No _________
This questionnaire is part of a study to understand the factors that affect the smoking habits of people. If you may spare the time to provide your input to the best of your abilities, it would serve to be a valuable contribution for the study.
Please Note: All information concerning your identity will be kept confidential and private. Information concerning your personal identity will not be shared with any third party. This survey does not bind you to any legal prosecution, nor any liability thereof.
Specify your gender
Male
Female
Which age group do you belong to?
18 or younger
19-24
25-29
30-34
35-39
40-44
45-49
50 or older
Specify your nationality
US
Serbia
Ireland
UK
Which nursing position are you currently employed as?
Registered Practical Nurse
Registered Nurse
Nurse Practitioner
When was the last time you smoked a cigarette?
Do not smoke
A few months ago
Last week
Yesterday
How often do you smoke?
Never smoked
Quit smoking
Seldom
Casually
Routinely
Do any of the male nurse peers smoke around you?
Yes, all of them
Some, not all
Not in plain sight
Do any of the female nurse peers smoke around you?
Yes, all of them
Some, not all
Not in plain sight
Do male nurses share their cigarettes with female nurses?
Yes
No
How would you best describe your financial standing?
It’s tough, could do better with a higher salary
Satisfactory
Ample and contended
Surplus with privileges
How would you describe your work load?
Stressful, and trying to cope
Manageable
Comfortable with more time to think
Lassiez-Faire
Do you have any dependents to take care of?
Yes, with children
Yes, only elderly family members
No, but with a partner
Appendix 2 – Survey Results
Appendix 3 – Data Analysis
