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Workplace Impact on Nurses’ Smoking Behaviors

Petersen, Anne Berit, PhD, MPH, RN, CNS; Sarna, Linda, PhD, RN, FAAN; Rezk-Hanna, Mary, PhD, NP; Wells, Marjorie, PhD, RN, FNP; Nohavova, Iveta, MS, RN; Bialous, Stella, DrPH, RN, FAAN

doi: 10.1097/NCC.0000000000000696
Article: PDF Only

Background Europe continues to have among the highest worldwide prevalence of adult smoking (28%) and the highest among females (19%). Nurses’ rates of smoking in the region are comparable or higher than the general female population. Nurses who smoke are less likely to intervene with patients who smoke; therefore, supporting nurses’ efforts to quit is critical to promoting nurses’ well-being and strengthening the profession’s impact on prevention of tobacco-induced diseases.

Objective The aim of this study was to explore nurses’ perceptions of hospital workplace factors that influence nurses’ smoking and quitting behaviors in Central and Eastern Europe.

Methods Each country had a project director involved in the recruitment of participants and the translation of instruments. Using a moderator guide, focus groups (N = 9) about smoking and quitting were conducted in 5 countries (Czech Republic, Hungary, Romania, Slovakia, Slovenia) among 82 nurses who self-reported as current or former smokers. Recorded transcripts were translated and analyzed using content analysis methods.

Results The majority of nurses were female (94%) and currently smoking (65%). Four major themes were identified that describe workplace factors influencing nurses’ smoking behaviors and efforts to quit: (1) taking breaks, (2) effect of smoking on patient interactions, (3) perceived collegial support for quitting, and (4) impact of workplace policies.

Conclusions Workplace factors influence nurses smoking and quitting behaviors.

Implications for Practice Changes in healthcare systems and policies are needed to support nurses’ quit efforts. Additional education is needed to ensure that nurses understand issues related to smoking and interactions with patients.

Author Affiliations: School of Nursing, Loma Linda University, California (Dr Petersen); School of Nursing, University of California Los Angeles (Drs Sarna, Rezk-Hana, and Wells); School of Nursing (Dr Bialous) and Center for Tobacco Control Research and Education (Drs Petersen and Bialous), University of California San Francisco; and Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University; General University Hospital; and Society for Treatment of Tobacco Dependence (Ms Nohavova), Prague, Czech Republic.

Support was provided by a grant from the Bristol-Myers Squibb Foundation Bridging Cancer Care Initiative to the International Society of Nurses in Cancer Care, by the UCLA School of Nursing, and by a National Cancer Institute training grant (A.B.P. was a postdoctoral fellow at the UCSF Center for Tobacco Control Research and Education when this manuscript was written; T32CA113710). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

The authors have no conflicts of interest to disclose.

Correspondence: Stella Bialous, DrPH, RN, FAAN, Department of Social Behavioral Sciences School of Nursing, University of California San Francisco, 3333 California St, San Francisco, CA 94143 (

Accepted for publication December 10, 2018.

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