New research shows that smoking rates among nurses have taken a major dive—a phenomenon that experts say will have ripple effects throughout the health care system.
The proportion of registered nurses (RNs) who smoke dropped by more than a third between 2003 and 2011, according to a study by Linda Sarna, PhD, RN, FAAN, professor and Lulu Wolf Hassenplug Endowed Chair at the University of California, Los Angeles (UCLA), School of Nursing and a Robert Wood Johnson Foundation (RWJF) grantee.
“We were thrilled to see the decline in smoking among registered nurses,” she said, adding that patients will benefit from the decline too. “The smoking status of the health care provider matters,” Sarna explained. Studies show that nurses and other health care professionals who smoke may be less likely to engage in full smoking-cessation interventions with patients and send mixed messages about the importance of quitting.
For the study, Sarna and her research team analyzed data on health care professionals from a tobacco-related portion of the U.S. Census Bureau’s Current Population Survey. The study found that RN smoking rates held relatively steady between 2003 and 2007 and then went into a sharp decline, falling from 11 percent in 2007 to 7 percent in 2011. The drop represents a 36 percent decrease in smoking rates among RNs, more than twice the 13 percent decline among the general U.S. population during the same time period. RNs were also more likely to quit smoking than peers in the general population, the study found.
LPN Rates Still High
Smoking rates among physicians, pharmacists, respiratory therapists, and dental hygienists also dropped. However, licensed practical nurses (LPNs) did not see significant declines; about 25 percent said they still smoke, according to the study. “We really have to focus on the LPN, whose smoking rates continue to remain the highest among all health care professionals,” Sarna said.
The study was published in January as part of a special edition of JAMA: The Journal of the American Medical Association commemorating the 50th anniversary of the U.S. Surgeon General’s landmark report about the dangers of smoking.
Sarna explained the findings as the result of changing cultural norms that are discouraging cigarette use. Hospitals and academic institutions, meanwhile, have banned on-campus smoking in recent years. And more smoke cessation resources are available, including new medicines and a national telephone quit line (1-800-QUIT NOW).
Tobacco Free Nurses, a national campaign led by Sarna and Stella Aguinaga Bialous, DrPH, RN, president of Tobacco Policy International, also played a role, she said. Founded in 2003, the RWJF-funded program aimed to dissuade nurses from smoking as a way to prevent smoking-related health problems among them and their patients. Its goals were to support and assist smoking cessation efforts among nurses and nursing students; enhance the culture of nurses as leaders and advocates of a smoke-free society; and give nurses tobacco control resources to use in assisting patients with cessation efforts.
“Nurses are the largest group of health care professionals,” Bialous said in a news release. “We knew that if we provided nurses with the education and resources to stop smoking, they in turn could help their patients quit. We are very encouraged that one decade after we launched our initiative, the culture of smoking among nurses has taken such a dramatic turn.”
“RWJF took a risk to fund this type of program,” Sarna added. “And we really do feel we have made a difference.”