Tobacco Smoking among Nursing Students - Essay Example

? Tobacco smoking among nursing Tobacco smocking is the most important preventable factor that causes death and influences the health and well being of the population around the world. This is important if we know that tobacco smoking is the second most important cause of death worldwide, after hypertension (WHO 2011). As a comparison in United States more people die from tobacco smoking every year than from motor vehicle accidents, alcohol and drug use, AIDS, suicides and murders combined together. It is estimated that in United States one of 5 deaths is due to tobacco smoke or complications due to tobacco use (CDC 2008). Based on the data from World health organization cigarette smoking and other forms of tobacco use kill more than 4 million people worldwide every year, with about 1.25 billion active smokers worldwide. With the same trends of tobacco use it is estimated that tobacco smoking will kill 8.4 million people a year by year 2020 (WHO 2000). Now even though these numbers are alarming the advertising of tobacco smoking is increasing in volume and specificity. It is estimated that in year 2006 in United States, the 5 largest tobacco companies spend 12.50 billion dollars on advertising, or more accurately more that 34 million dollar per day in advertising and promoting cigarette smoking. What is most important is that the as the cigarette smoking declines, the amount of money spend on advertising is drastically increasing (Slater et al 2007). Also some new price strategies that are designed by the tobacco companies, like price discounts that are paid to wholesaler and large distributors to lower the price of the cigarettes, actually lead to increased number of smokers among youth and adolescents in United States (Federal Trade Commission 2006). The advertising in tobacco industry goes as far as designing cigarettes that are specially attractive and appealing to women, where the targeting of women as smokers goes beyond marketing because the companies try to find specific factors of motivation, patterns of social activities associated with smoking, specific product preferences etc. in order to produce gender or age specific products (Carpenter et al 2005). As we can see the tobacco industry is a strong factor that is promoting the use of tobacco neglecting the negative effects of smoking in the process. Since tobacco smoking is a major health problem, the health system has very important role in promoting the negative effect of smoking and its participants: doctors, nurses, public health workers and other medical personnel. As stated by World health organization the public health community and health professionals should lead the way in solving the problem of tobacco use (WHO 2000). The role of health professionals is important because there are studies that show that the chances of smoking cessation increases after a patient receives advice from a health care professional (Fiore et al. 2000). There are many programs in the world designed to reduce the incidence tobacco use among physicians and other health care professionals around the world. There are information’s that indicate that maximum 10 percents of physicians in Australia, Norway, Canada, United States, United Kingdom and other developed countries smoke tobacco. This incidence is much higher among the countries in Europe. As opposite of this up to 40 percent or more of the physicians smoke in France, Italy, Spain, Turkey and other countries in Europe (WHO 1993). This is interesting because the study conducted by Emanuela and Anna 2009 also showed that incidence of tobacco use has very similar incidence among nursing students attending the 3 year full-time course at the University of Milan, Italy. This only means that we still don’t understand the etiological factors behind persistent high incidence of tobacco use among health-care professionals in Italy. This is why there is a need of further exploration and research in order to better understand why incidence of tobacco use amoung healthcare professionals remains unchanged over the years. We may look into the measures and activities that were conducted in other countries in order to reduce this incidence. In a study conducted by Derek 2008 where in a process of research of relevant medial journals regarding the tobacco use among physicians in United States it was found that in the post World war 2 period there were no difference in tobacco use between the general population and health care workers. However doe to specific campaigns targeting specifically medical personal and physicians, anti-tobacco advertisements in medical journals, the incidence of tobacco use among physicians in United States was significantly reduced. As the author concludes further in the study, these trends are not characteristic for other countries where medical personal has high incidence of tobacco use (Derek 2008). These results are also characteristic for the results obtained in the study conducted by Emanuela and Anna 2009. In this study they investigated the attitudes to smoking among nursing students that were attending the 3 year course at the University in Milan, Italy. The collection of data was made by sending e-mail to the coordinator of every group of students that were scattered in different hospitals in the city and a total of 944 student’s agreed to participate in the self-administered questionnaire, composed of different questions about tobacco smoking. 820 of the student completed the questionnaire that had several questions that were targeting some area of interest in the study. The questions students answered were correlated with personal professional background, personal history of tobacco smoking and tobacco history of their family and friends. Also some quantitative information’s were obtained from the smokers and ex-smokers. Smokers answered how much cigarettes they smoke in a day and the starting age of smoking. Ex-smokers were answering questions about the starting and end date of their smoke history and the reason for smoking cessation. As we can see in this study the primary goal was to find the quantitative information’s regarding the incidence of smokers and non smokers among nursing students and the tobacco history of the closest social environment of the students. They found that a total of 44.2 percents of the nursing students were smokers, and 12.4 percents of the non smoker students were ex-smokers. There was no significant difference between employed and non employed students regarding the incidence of smoking. Regarding the importance of smoking status of the family and friends of the students that were active smokers it was found that smokers had higher incidence of one or more of their parents being a smoker. The same results were obtained for the status of brothers, sisters and friends of the student that were active smokers (Emanuela and Anna 2009). We must note that in this study the information’s obtained from the population of nursing students were no specific for this population, but information’s that may be of relevance to the general population. Nursing students however have some characteristics that are different from the general population and any research conducted on them must respect that fact. -Nursing students have wider understanding and information’s regarding the medical and health aspects of smoking and side effects of tobacco smoking. - They get in contact with patients that suffer from different complications of tobacco smoking. - They are involved in educational and promoting activities regarding smoking cessation withing the hospitals that they attend theirs course. - They have personal attitudes and opinions regarding smoking, smoking cessations, the risks of smoking, psychological and physical effects of the smoking that are not known by the general population. - They have access to different promotional anti-smoking materials, information’s about negative effects of smoking etc. And a number of other differences that distinguishes them from the general population. Every study that tries to explore the smoking habits among nursing student and medical personal must include specific questions regarding these differences. It is interesting to mention that these results obtained by Emanuela and Anna 2009 are similar to results from other studies that were conducted in Italy regarding the incidence of tobacco use among nursing students in Italy. The results regarding the incidence of tobacco smoking among nursing students were very similar to the study conducted on the nursing students by Melani et al. 2000 at the University of Siena and Florence in Italy. They found that a total of 43 percents of the nurse students were active smokers. However in the study they also evaluated the smoking habits, personal beliefs and attitudes towards tobacco smoking among nurse students. In the study they also explored the general knowledge of the nursing students about the tobacco smoking hazards and their role as a medical personal in promoting tobacco smoking cessation (Melani et al. 2000). We must conclude that these are important information’s regarding tobacco usage among nursing students because the purpose of these studies is to actually better understand the behaviors and agitates toward tobacco smoking in nursing students. In another study conducted by Maria et al. 2009 they conducted a research where they explored the personal and occupational data of the participants (medical personal, doctors, nurses, students etc.), but also thy investigated their knowledge and attitude towards tobacco smoking, their job settings and a number of other factors of interest. In this study they found that smoking prevalence among medical personal is very similar to the above mentioned studies (44 percents). However they obtained a number of other information’s from the participants regarding tobacco usage. For example 90.5 percents of the participants have seen their colleagues smoking inside the hospital, but nevertheless 67.7 percents of the participants declared that health-care professionals are role models for the citizens and patients regarding tobacco smoking. The study is more specific about the most common places where the medical personal smokes inside the hospitals (toilets, kitchens and even patients rooms) (Maria et al. 2009). As we can see in this study even though health care professionals agreed that they are roll-models for the patients regarding tobacco smoking they smoked tobacco inside the hospitals and even inside patient rooms. Based on the above mentioned studies we can conclude that every study that tries to explore the tobacco usage among medical personal must involve some specifics regarding their role as health-care professionals. We need more information’s, other than the incidence of tobacco smokers among medical personal and their relation with family, friends and colleagues. We must also obtain knowledge of the personal attitude of the health-care professionals regarding tobacco smoking, their knowledge of their role as roll-models towards the patients, their obligations to promote tobacco cessation and inform the patients about the negative effect of smoking. Any research of this subject must also include information’s regarding hospital’s policies towards health-care professional who smoke the eventual implementation of punishment of medical personal that smokes within the hospitals, the system of education for tobacco smoking cessation among medical personal etc. We can conclude that the study conducted by Emanuela and Anna 2009 has important information’s regarding the incidence of tobacco smoking among nursing students. Their method of data collection was well planned because the questioners were distributed by group coordinators and therefore they included significant percentage of the nursing students (87 percents). However we must conclude that any further study must obtain additional information’s regarding personal attitudes and other information’s regarding tobacco usage among nursing students and medical personal in general in Italian hospitals and universities. References: World health organization 2011, World No Tobacco Day, Media centre, 31 May 2011 Centers for Disease Control and Prevention-CDC (2008). Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Morbidity and Mortality Weekly Report 2008;57(45):1226–8 Slater, SJ, Chaloupka FJ, Wakefield M, Johnston LD, O'Malley PM. The Impact of Retail Cigarette Marketing Practices on Youth Smoking Uptake. Archives of Pediatric and Adolescent Medicine. May 2007; 161(5):440-45 Federal Trade Commission (2006), : Smokeless Tobacco Report for 2006. Issued August 2009. Carpenter, C. M., Wayne, G. F., & Connolly, G. N. (2005). Designing cigarettes for women: New findings from the tobacco industry documents. Addiction, 100, 837-851. World health organization – WHO (2000), Bulletin of the World Health Organization, Print version ISSN 0042-9686, Bull World Health Organ vol.78 no.7 Genebra July 2000 Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence: clinical practice guideline. Rockville, MD: US Department of Health and Human Services, Public Health Service; 2000. World Health Organization. World No-Tobacco Day -- 31 May 1992 {Advisory kit}. Geneva: World Health Organization, 1993. Emanuela Biraghi and Anna Maria Tortorano (2009), Tobacco smoking habits among nursing students and the in?uence of family and peer smoking behaviour, Journal of advanced nursing, Journal compilation, 2009 Blackwell Publishing Ltd, Accepted for publication 13 July 2009 Derek R Smith (2008), The historical decline of tobacco smoking among United States physicians: 1949–1984, 2008 Smith; licensee BioMed Central Ltd., Published online 2008 September 9. doi: 10.1186/1617-9625-4-9, PMCID: PMC2556033 A.S. Melani, W. Verponziani, E. Boccoli, G.L. Trianni, A. Federici, R. Amerini, M.G. Vichi and P. Sestini (2000), Tobacco smoking habits, attitudes and beliefs among nurse and medical students in Tuscany, EUROPEAN JOURNAL OF EPIDEMIOLOGY, Volume 16, Number 7, 607-611, 2000, DOI: 10.1023/A:1007697126844 Maria G. Ficarra, Maria R. Gualano, Silvio Capizzi, Roberta Siliquini, Giorgio Liguori, Lamberto Manzoli, Lamberto Briziarelli, Antonino Parlato, Pasquale Cuccurullo, Roberto Bucci, Simone Chiado Piat, Giuseppe Masanotti, Chiara de Waure, Walter Ricciardi and Giuseppe La Torre (2009), Tobacco use prevalence, knowledge and attitudes among Italian hospital healthcare professionals, European Journal of Public Health, Volume21, Issue1, Pp. 29-34, Received November 7, 2009, Accepted February 1, 2010, doi: 10.1093/eurpub/ckq017. Read More