Evaluation of a Worksite Self-Help Smoking Cessation Program for Registered Nurses

Abstract

Cigarette smoking among nurses remains a public health concern despite a recent decline in current smoking prevalence. We recruited 149 registered nurses into a no-cost, targeted, self-help smoking cessation program supplemented by a supportive worksite environmental module. The study was designed to expand understanding of nurses' smoking and to measure program effectiveness. Follow-ups were conducted at one, six and 12 months post-intervention to assess self-reported smoking status (92% objectively validated) and predictors of cessation. Point prevalence abstinence at these time points (22.5%, 21.5% and 19.5%), continuous abstinence (12.7%), and an ever-quit rate of 57% (i.e., quit for at least 48 hours), compare favorably to population quit rates and to rates reported for other self-help programs. Logistic regression analyses were utilized to identify predictors of short-term cessation [time before needing a cigarette, concern regarding the health hazards of smoking, working in a critical care setting, use of targeted weight manual] and long-term cessation [dosage (inverse relationship), use of standard American Lung Association maintenance manual, working with dying patients, and M.D.s' opposition to upgrading nursing service (inverse relationship)].

Nurses, smoking, and the workplace

“…Although nurses have contributed to the knowledge of the morbidity and mortality caused by tobacco use among women through their participation in the Nurses Health Study (US Department of Health and Human Services, 2001), there have been limited efforts to assist nurses with smoking cessation (Chalmers et al, 2001;Gritz et al, 1988;Rowe & Clark, 1999). One research group (Gritz et al, 1988), in a study of nurses' workplace smoking and quitting (n ¼ 149 in 15 acute care hospitals in Los Angeles, reported a 12.7% point prevalence quit rate at 12 months. Chalmers et al (2001) conducted an 8-week support group, community-based intervention for Canadian nurses (n ¼ 217).…”

“…In the current health care climate, nursing is a valued, but stressful occupation (American Nurses Association, 2002), with many nurses working 12-hour shifts. The evidence for the association of stress in the workplace and smoking among nurses has been inconsistent, yet stress has been cited as a barrier to their ability to quit (Berman, Read, Marcus, & Gritz, 1992;Gritz et al, 1988;McKenna et al, 2003). Lack of support from co-workers has been identified in some studies as a reason for fewer quit attempts Bramadat et al, 1999;Gritz et al, 1988;Rowe & Macleod-Clark, 2000).…”

“…However, as workers bond over stressful events, social support in the work site may actually sustain smoking. In the study by Gritz et al (1988), the investigators postulated that the poor social support skills of the buddy and the unsuccessful quit attempts by the buddy might have negatively influenced quit attempts. Although intention to quit has been associated with perceptions of greater levels of social disapproval of smoking, as well as social support for quitting (Sorensen et al, 2002), in our findings smokers and former smokers did not appear to perceive tremendous social pressure or support from management to quit.…”

“…Several researchers have studied smoking prevalence and attitudes of nurses and nursing students (e.g., Clark, McCann, Rowe, & Lazenbatt, 2004;Hughes & Rissel, 1999;Jenkins & Ahijevych, 2003;McKenna et al, 2003;Rowe & Macleod-Clark, 2000; L. Stubbs, Haw, & Garner, 2004), however, research supporting effective strategies to promote smoking cessation among nurses is scarce (Bramadat, Chalmers, Cantin, Hydesmith, & Scott-Findlay, 1999;Gritz et al, 1988;Rowe & Clark, 1999).…”

A Smoking Reduction and Cessation Program With Registered Nurses: Findings and Implications for Community Health Nursing

“…Gritz et al (1988) reported a work-site oriented, self-help intervention with 149 registered nurses, based on the use of the American Lung Association manuals. Gritz et al (1988) reported a work-site oriented, self-help intervention with 149 registered nurses, based on the use of the American Lung Association manuals.…”