Nursing News

Smoking Rate Among RNs Shows a Healthy Decline

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By Jennifer Larson, contributor

January 13, 2014 - If you’ve recently stopped smoking, congratulations! You’ve contributed to a significant decline in the number of registered nurses who smoke in recent years. You’re also contributing to your own personal health and that of your patients, many health advocates say.

A team of researchers recently analyzed smoking among health care professionals during the 2010-2011 time period and found that the rate of smoking among this group was approximately half that of the general population. The percent of health care professionals who smoke was reported at 8.3 percent, compared to 16.1 percent of the general population.

The study also found that registered nurses logged the most significant decrease in smoking between 2006-2007 and 2010-2011; the percentage of RNs who smoked declined from almost 11 percent to about 7 percent--a 36 percent drop.

Linda Sarna: New study shows rate of RNs who smoke has dropped.
Linda Sarna, PhD, RN, and fellow researchers found a significant drop in the percentage of nurses who smoke compared to just a few years ago.

“That is huge,” said researcher Linda Sarna, PhD, RN, professor of nursing at the UCLA School of Nursing. “We were thrilled to see this.”

Sarna and her research colleagues published their results in the January 7, 2014 issue of JAMA

Some nurses do still smoke 

One significant problem area identified by the researchers: licensed practical nurses (LPNs) report a much higher rate of smoking than all other health care professionals--and even the general population. The percentage of LPN smokers in the recent study was reported at 25 percent, representing a 21.6 percent increase over the 20.6 percent reported in 2006-2007.  

“It’s time for LPNs to take that big leap,” said study co-author Stella Bialous, DrPH, RN, who frequently collaborates with Sarna through the Tobacco Free Nurses initiative. 

While the percentage of RNs who smoke is much lower than that of the LPNs, there is still room for improvement in the 7.1 percent who admit to smoking. For comparison, the percentage of physicians who smoke hovers under 2 percent.

“We want the nurses to be as low as the physicians,” Sarna said. 

A barrier to tobacco interventions with patients 

Evidence shows that smoking is harmful to your health in a multitude of ways. For example, smoking increases a person’s risk of coronary heart disease and stroke, by two to four times, according to the Centers for Disease Control and Prevention (CDC), and it greatly inflates the chances of developing lung cancer.

Wendy Bjornson, MPH, co-director of the OHSU Smoking Cessation Center at Oregon Health and Science University, said that the benefits of quitting smoking represent the most credible information any health professional can provide to their patients.

“I believe that when the message is delivered by a nonsmoker, it is likely to more believable,” she added. 

The researchers emphasized that smoking by nurses and other health care professionals is a barrier to tobacco interventions with patients. It’s already challenging for health care professionals to get a stop smoking message across to patients who are addicted to nicotine or may be reluctant to try quitting--or try again. It may be even more difficult if the patient knows the nurse hasn’t yet kicked the habit.

“The role modeling is important, as it is in other areas,” Sarna noted. 

It’s also hard to hide smoking, she added. “They may try to hide their smoking, but you can tell. You can smell it.”

And role modeling for patients isn’t the only issue; nurses who smoke also affect the views of the general public.

As more health care campuses have gone smoke-free--a positive development, the researchers emphasized--smokers have been pushed out to the fringes to get their fix. Consider the image of a person dressed in scrubs, dangling a lit cigarette from her fingers, on a sidewalk next to a busy street, in full view of other pedestrians and motorists.

“The public perception is that everybody outside who is smoking is a nurse,” even though many other people wear scrubs on the job, said Bialous. “There is that perception.”

Nurses shouldn’t lend credence to that assumption, she said, adding that the last thing that nurses want is for patients to say, “Well, if it’s so bad, why are the nurses doing it?”

Why do any health professionals smoke? 

Armed with their knowledge of the dangers of tobacco use, some might ask why any health care professionals would choose to smoke.

“We know that nicotine is terribly addictive,” said Sarna. “It’s tough to quit.”

In fact, most smokers need multiple attempts to succeed at quitting, according to the American Lung Association. Many relapse because it’s a stressful process, and they get discouraged.

Nurses are human, with the same vulnerability as others, said Bialous. That’s why providing non-judgmental support to nurses who want to quit is so important. They may already feel some guilt from the “Nurses should know better” mindset that many people have.

Once they do quit, nurses can use their experience when working with their patients struggling with the addiction. “That is one thing that they can really appreciate,” Sarna said.



* Learn more about the Tobacco Free Nurses Initiative.
* Talk to a National Cancer Institute smoking cessation counselor by calling 1-800-QUIT NOW.

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