On the eve of the 50th anniversary of the U.S. surgeon general's first report alerting the nation to the negative health consequences of lighting up, there is good news about registered nurses who smoke: There are a lot less of them.
A new UCLA study tracking changes in smoking prevalence among nurses and other health care professionals between 2003 and 2011 found that the proportion of registered nurses who smoke dropped by more than a third during that period.
The findings appear in the January issue of JAMA: The Journal of the American Medical Association, which commemorates the surgeon general's landmark 1964 Report on Smoking and Health.
The study's principal investigator, Linda Sarna, a professor at the UCLA School of Nursing and oncology nurse who has been committed to tobacco cessation for the past two decades, said she was energized by the results.
"This decline is so important, not just for the health status of nurses but because studies continue to show that smoking by health care professionals sends a mixed message to patients," she said.
The study used data on health care professionals from the Tobacco Use Supplement for 2003, 2006–07 and 2010–11; the supplement is administered as part of the U.S. Census Bureau's Current Population Survey.
While the researchers found no significant decline in smoking among registered nurses between 2003 and 2007, the years from 2007 to 2011 witnessed a big drop. The data show that the proportion of registered nurses who smoke dropped from 11 percent to 7 percent — an overall decrease of 36 percent and more than two times the 15 percent decline among the general U.S. population during the same time period.
In addition, the proportion of nurses who smoked and have quit (approximately 70.3 percent) was higher than the general population (roughly 53.6 percent).
"Nurses see every day the devastation smoking has on their patients," said Sarna. "Much has changed since the 1970s, when female nurses had higher smoker prevalence than women in the general population."
For all health care professionals included in the analyses — physicians, registered nurses, licensed practical nurses, pharmacists, respiratory therapists and dental hygienists — there continues to be a decline in smoking. Physicians have with the lowest proportion of current smokers, at approximately 2 percent. The other good news from the survey is that the majority of health care professionals, some 77.9 percent, never started smoking to begin with, a figure much lower than the general population's 65.3 percent.
Sarna pointed out that smoking is still problematic among licensed practical nurses, with nearly a quarter of all LPNs contining to smoke.
"We really have to focus on the LPN, whose smoking rates continue to remain the highest among all health care professionals," she said.
Stella Aguinaga Bialous, president of Tobacco Policy International, believes the dramatic results are due in major part to the trend of hospitals banning smoking on their property, as well as a focused campaign targeting nurses to quit. Bialous and Sarna founded the group Tobacco Free Nurses in 2003 to provide support for nurses who smoke, as well as to establish a framework for engaging nurses in tobacco-use prevention and cessation.
"Nurses are the largest group of health care professionals," Bialous said. "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."
Sarna and Bialous' co-authors on the study, "Changes in Smoking Prevalences Among Healthcare Professions from 2003–2010/11," include Karabi Nandy and Anna Liza Malazarte Antonio, both of the UCLA School of Nursing, and Qing Yang of RTI Health Solutions.
To learn more about the UCLA School of Nursing, visit nursing.ucla.edu.