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• Nurses not immune to nicotine addiction  

Despite seeing smoking's health effects firsthand, the rate at which U.S. nurses quit smoking has been no faster than for other women, researchers say.

The findings from researchers at the University of California in Los Angeles describe smoking trends among U.S. nurses enrolled in the Nurses' Health Study between 1976 and 2003. The study, begun at Brigham and Women's Hospital, is based on surveys completed every two years by 237,648 female registered nurses.

"Nurses in the study demonstrated behavior patterns similar to women in the general population," lead study investigator Linda Sarna said in a statement. "For example, the younger nurses in the study began smoking before entering the profession, a pattern reflected by American women starting smoking at younger ages in general. Being a nurse did not make these women immune to nicotine addiction."

The study, published in Nursing Research, found the rate of smoking among women in the study declined from 33.2 percent in 1976 to 8.4 percent in 2003

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• Smoking's Effect On Nurses' Health, Death Rates Revealed By UCLA Study 

A new UCLA School of Nursing study is the first to reveal the devastating consequences of smoking on the nursing profession. Published in the November-December edition of the journal Nursing Research, the findings describe smoking trends and death rates among U.S. nurses and emphasize the importance of supporting smoking cessation programs in the nursing field.

"Nurses witness firsthand how smoking devastates the health of their patients with cancer and respiratory and cardiovascular diseases," said principal investigator Linda Sarna, D.N.Sc, a professor at the UCLA School of Nursing. "Yet nurses struggle with nicotine addiction like the rest of the 45 million smokers in America. We are concerned that nurses who smoke may be less apt to support tobacco-control programs or encourage their patients to quit."

Sarna led a team of researchers who analyzed data from the Nurses' Health Study, a historic study on women's health. Launched at Brigham and Women's Hospital in the mid-1970s, the study relied upon surveys completed every two years by 237,648 female registered nurses about their health, including smoking habits. . . .

According to the most recent data, the smoking rate among registered nurses nationwide is nearly 12 percent.

The rate of smoking among women in the Nurses' Health Study declined from 33.2 percent in 1976 to 8.4 percent in 2003. The number of cigarettes smoked per day also dropped. However, the daily number among current smokers still averaged more than 15 cigarettes, or over half a pack.

"When the Nurses' Health Study began in 1976, nursing education gave limited attention to smoking's effect on health. Today, the amount of time devoted to tobacco cessation in the curriculum remains inadequate," Sarna said.

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• Big Tobacco and the California Nurses Association: Happy Together 

With Democratic legislators and the Governor on the verge of an agreement on the nation's most sweeping comprehensive health care reform plan, its political foes already are circling. Two of the strangest bedfellows certain to fight the plan will be Big Tobacco and the Nader-endorsing leadership of the California Nurses Association.

Big Tobacco began its lobbying campaign earlier this week, routing calls to legislative offices with anti-consumer messages. And today, CNA-backed single payer advocates began an email campaign to Capitol offices. . . .

All of this will make it very interesting for hear CNA's leadership explain to its rank-and-file members who want health care reform how climbing in bed with tobacco and insurance company interests will improve the quality of care for Californians.

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• High Prevalence of Smoking Among Physicians in China 

FINDINGS: With 360 million smokers, China has more cigarette consumers than any other country — a smoking prevalence of 31 percent among the general population. Physicians can play a key role in encouraging smokers to quit, yet up to now, little has been known about Chinese physicians' attitudes and practices regarding smoking. In this first-of-its kind-study, researchers found that 23 percent of 3,552 hospital-based physicians surveyed were smokers, substantially higher than in the United States (3.3 percent), where the smoking prevalence in the general population is 20.9 percent, and the United Kingdom (6.8 percent), with 25 percent prevalence in the general population. This rate is also higher than in Japan (20.2 percent), where the smoking prevalence in the general population is 33.8 percent.

IMPACT: The findings are noteworthy because physicians who smoke are significantly less likely than their nonsmoking counterparts to advise their patients to quit smoking. As a result of this survey, the China Center for Disease Control has instituted an antismoking campaign that targets physicians and medical students and promotes smoke-free hospitals.

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• Hospitals weigh bans on smoking  

More than a quarter-century later, despite being a nursing supervisor at a busy trauma center, McCandless has no plans to stop her two-pack-a-day habit. Three to four times during a 12-hour shift, McCandless takes a break and smokes in the hospital's designated area.

She knows the health risks.

"But I like smoking," McCandless, 36, said during a break at Louisville's University Hospital emergency room. "I don't have a desire to quit."

McCandless' quest to smoke at work will likely get tougher in coming months.

Following national smoking-prohibition trends, more and more hospitals are banning smoking on their properties. A recent survey showed about half of the Chicago area's 96 hospitals have done so or are planning for it.

Across America -- even here in the heart of tobacco country -- health-care establishments are fed up with people, including patients hooked to intravenous units and nurses who treat them, smoking on their premises.

As they consider bans, hospitals are becoming more aggressive in persuading their practitioners to stop smoking, not only because of concerns about their health but also because the use of tobacco by health professionals sends a hypocritical message to patients.

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• Smoking Cessation Therapy May Be Harmful for ICU Patients 

A common smoking cessation therapy used to help reduce adverse events associated with nicotine withdrawal may actually increase the risk of death for smokers admitted to the intensive care unit (ICU). In a new study presented at CHEST 2006, the 72nd annual international scientific assembly of the American College of Chest Physicians (ACCP), researchers found that smokers admitted to the ICU who received nicotine replacement therapy (NRT) during their stay had a higher risk of death than smokers who did not receive NRT.

"In some critically ill patients, the development of nicotine withdrawal symptoms can worsen their prognosis. As a result, NRT is given to active smokers in the ICU to prevent nicotine withdrawal symptoms," said lead researcher Amy Lee, MD, Mayo Clinic College of Medicine, Minneapolis, MN. "The hemodynamic effects of nicotine may lead to increased heart rate, systemic arterial blood pressure, and constriction of the coronary arteries. Although these potential adverse effects of NRT have not been shown to worsen the prognosis of healthy volunteers and patients with stable coronary artery disease, they may be detrimental in critically ill patients."

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• NHS CUTS HALT CIGS CRUSADE 

A CAMPAIGN to help NHS nurses quit smoking has been scrapped by the Health Department because of budget cuts.

Under the Choosing Health drive, nurses who smoked were to be targeted with nicotine replacement therapy, anti-smoking support and a phone helpline.

The idea was to make them role models for patients who wanted to quit. But the Royal College of Nursing revealed the project has now been put on hold because the Department of Health has withdrawn its funding.

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• Nursing Research - July/August 2006, Volume 55, Issue 4 Supplement 1  

• Nurses join forces to address Reynolds American 

Some registered nurses from across the country has become Reynolds American Tobacco shareholders so they can speak out about the tobacco-related problems they see in their work.

"The Nightingales" plan to address the C-E-O of Reynolds American at the company's annual shareholders meeting on May third.

A statement from the group says it plans to ask the company to end all active marketing and promotion of cigarettes. It's a move they say will protect children, save lives, generate goodwill for the company and demonstrate genuine corporate responsibility.

Ellen Hahn, a registered nurse and director of the Kentucky Center for Smoke Free Policy says it's time to stop encouraging addiction.

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• Tobacco prevention in children and cessation in family members (Abstract) 

Conclusions: The student program resulted in significant improvements in drug knowledge, refusal skills, attitudes, normative expectations, assertiveness, and anxiety reduction techniques. In addition, the effectiveness of several components of the tobacco prevention program for the children was impacted by the smoking status of their parents/guardians. Drug-use intentions and behaviors were lower at posttest for children from homes of nonsmokers versus children from homes of smokers. Parents/guardians consistently reported that smoking was detrimental to themselves, the public, and their children. Of those parents/guardians who identified themselves as smokers (26%) and received cessation materials, 46.4% indicated that the information motivated them to want to quit.

Implications for practice: Tobacco use continues to be the leading cause of preventable death in the United States, with greater than 2000 new youth becoming regular smokers each day. School nurses and nurse practitioners are in various pivotal positions to address tobacco and its related health concerns through delivery of effective family interventions that target children for tobacco prevention and parent/guardian smokers for cessation.

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• LETTER: Nurses won't turn their backs on smokers 

Your piece on smoking in the home (News, last week) misrepresented the Royal College of Nursing's view on the subject of patient-smoking.

The RCN guidelines are designed to inform managers and staff about ways to prevent and reduce staff exposure to secondhand smoke. They are for our members' use only and will not be sent to NHS trusts. The aim of the guidelines is to encourage dialogue between healthcare workers and patients about ways in which staff could be protected from secondhand smoke without compromising patient care.

The guidelines do not advocate withholding treatment from smokers and I am disappointed they were presented as such. For nurses, providing good quality nursing care comes first. To suggest that a nurse would refuse to visit a patient at home because of smoking is not only inaccurate, but it is wholly unfair to a profession whose primary concern is the patient.

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• Nurses fear assault if they tell patients not to smoke 

NURSES fear assault by some of Scotland's most disturbed patients after being ordered to ban smoking on the wards.

The ban, introduced five days ago, covers a number of people locked up at Dykebar psychiatric hospital in Paisley after being certified as dangerous.

Furious nurses and union leaders today claimed the ban could put staff at risk.

Psychiatric hospitals were declared exempt from the ban on smoking in enclosed public places being introduced in Scotland on March 26.

But NHS Argyll & Clyde chiefs have brought in their own tobacco policy banning patients as well as all staff, visitors and contractors from smoking in all health board premises or grounds.

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• Smokers face ban at home if nurse calls 

Hundreds of thousands of smokers will be banned from lighting up in their own homes when nurses or other health workers visit them, under controversial new rules drawn up by the nurses' professional body.

The move dramatically widens the scope of the public clampdown on passive smoking - taking it from the workplace or the pub into the living room. It will trigger fresh debate over the nature of personal freedom versus public health.

The Royal College of Nursing argues that nurses, midwives and health visitors whose jobs involve going out to visit new mothers or the frail and elderly, should not be forced to inhale smoke just because 'their workplace' is in other people's homes.

It will publish guidance shortly for NHS trusts stating that patients due a home visit should be instructed in writing that neither they nor their family can smoke during the visit or for an hour beforehand, creating a 'smokefree environment'

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• No off-duty smoking ban for staff 

Plans to stop NHS staff smoking while in uniform even if they are off duty have been rejected.

Suffolk East Primary Care Trusts' board decided on Wednesday health workers can light up out of work - as long as their shift is over.

The proposal was part of a drive to make all NHS buildings smoke-free by the end of 2006 and stop staff smoking.

Staff union Unison had warned a ban could force smokers underground, causing further health risks.

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• WHO urges health professionals to engage in tobacco control 

The World Health Organization (WHO) is encouraging health professionals to be proactive in minimizing the problems caused by tobacco addiction, consumption and exposure to tobacco smoke. As a result, this year's World No Tobacco Day on May 31st is dedicated to the important role of health professionals in tobacco control under the banner of 'Health Professionals against tobacco, action and answers'.

"Tobacco continues to be a leading global killer, with nearly five million deaths a year", notes Dr LEE Jong-wook, WHO Director-General, "The health community plays a key role in the global effort to fight this epidemic. Health professionals are on the frontline. They need the skills to help people stop smoking, and they need to lead by example, and quit tobacco use themselves."

Without additional efforts to implement solutions now, an estimated ten million tobacco-related deaths a year will occur by 2020, most of them in developing countries.

Health professionals, including doctors, dentists, pharmacists, nurses, midwives and others, are trusted sources of information and advice, and are themselves role models in matters related to health.

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