Keywords
prevalence
health personnel
health promotion
hospital
Abstract
Background
Health care professionals should work against smoking habit to promote a correct life style. This study aimed to evaluate smoking prevalence and attitudes towards tobacco among Umbrian hospital professionals in a period between 2006 and 2015, since the approbation of the law that ban smoking in hospitals and all public areas in 2003.
Methods
A cross-sectional study was carried out using a questionnaire administered in 2006, 2011 and 2015 to healthcare professionals. It consists of 53 multiple-choice questions. Potential predictors of current smoking habits were evaluated using univariate and multivariate logistic regression.
Results
The sample included 475 healthcare professionals. Current smokers constituted 34.53% of the sample and no significant difference (p=0.257) emerged in prevalence over time (33.74% in 2006; 36.02% in 2011 and 33.77% in 2015). The risk of being a smoker increased by not considering the smoking habit as the main cause of preventable deaths (Univ. OR=2.25; 95% CI: 1.47 – 3.45). The strongest risk factor, which was significant in both models (p<0.01), was being against the “No Smoking” law (Univ. OR=18.90; 95% CI: 2.43 – 147.71 ; Multiv. OR=22.10; 95% CI: 1.85 – 264.78).
Discussion
The hospital staff has higher prevalence of smoking than the general population. The No Smoking law alone has been shown to be inadequate. Effective results can be achieved only by a common strategy and shared intervention programmes that are based on a workplace health promotion strategy. That for the moment has demonstrated to give interesting outcomes in modifying deep-rooted behaviour patterns.References
Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA. 2014 Jan 8;311(2):183–92.
Doxa – ISS Survey, Smoking in Italy 2015. Avaible at: http://www.iss.it/fumo/index.php?lang=1&id=350&tipo=18. Accessed [10 sept 2015].
Ficarra MG, Gualano MR, Capizzi S, Siliquini R, Liguori G, Manzoli L, et al. Tobacco use prevalence, knowledge and attitudes among Italian hospital healthcare professionals. Eur J Public Health. 2011 Feb;21(1):29–34.
White IR, Royston P, Wood AM. Multiple imputation using chained equations: Issues and guidance for practice. Statist Med. 2011 Feb 20;30(4):377–99.
Gelman A. Bayesian Data Analysis. 2nd ed. London, New York: Chapman & Hall; 2004
Rubin DB. Multiple Imputation for Nonresponse in Surveys. New York; Chichester: Wiley; 1987
Gordon L, Modayil MV, Pavlik J, Morris CD. Collaboration with behavioral health care facilities to implement systemwide tobacco control policies--California, 2012. Prev Chronic Dis. 2015;12:E13.
Ballbè M, Martínez C, Saltó E, Cabezas C, Riccobene A, Valverde A, et al. Maintenance of tobacco cessation programmes in public hospitals in Catalonia, Spain. Addict Behav. 2015 Mar;42:136–9.
Neall RA, Atherton IM, Kyle RG. Nurses’ health-related behaviours: protocol for a quantitative systematic review of prevalence of tobacco smoking, physical activity, alcohol consumption and dietary habits. J Adv Nurs. 2016 Jan;72(1):197–204.
Trujillo Gómez JM, Díaz-Gete L, Martín-Cantera C, Fábregas Escurriola M, Lozano Moreno M, Burón Leandro R, et al. Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study. PLoS ONE. 2015;10(9):e0137415.
Giorgi E, Marani A, Salvati O, Mangiaracina G, Prestigiacomo C, Osborn JF, et al. Towards a smoke-free hospital: how the smoking status of health professionals influences their knowledge, attitude and clinical activity. Results from a hospital in central Italy. Ann Ig. 2015 Apr;27(2):447–59.
Shahbazi S, Arif AA, Portwood SG, Thompson ME. Risk factors of smoking among health care professionals. J Prim Care Community Health. 2014 Oct;5(4):228–33.
Lepage M, Renaud L, Champagne F, Rivard M. [Strategies to increase the brief interventions in smoking cessation among nurses in hospital settings: experimental study]. Rech Soins Infirm. 2014 Mar;(116):57–69.
Torjesen I. NHS hospitals must become completely smoke free, says NICE. BMJ. 2013;347:f7105.
Martínez C, Fu M, Martínez-Sánchez JM, Antón L, Fernández P, Ballbè M, et al. Impact of a long-term tobacco-free policy at a comprehensive cancer center: a series of cross-sectional surveys. BMC Public Health. 2014;14:1228.
Mahabee-Gittens EM, Khoury JC, Ho M, Stone L, Gordon JS. A smoking cessation intervention for low-income smokers in the ED. Am J Emerg Med. 2015 Aug;33(8):1056–61.
Aryayev M, Lowe JB, Kuzmenko T. The prevalence of and knowledge about tobacco use among physicians in the Odessa region, Ukraine. Eur J Public Health. 2014 Jun;24(3):474–6.
Hauri DD, Lieb CM, Rajkumar S, Kooijman C, Sommer HL, Röösli M. Direct health costs of environmental tobacco smoke exposure and indirect health benefits due to smoking ban introduction. Eur J Public Health. 2011 Jun;21(3):316–22.
Smith DR, Leggat PA. An international review of tobacco smoking in the medical profession: 1974-2004. BMC Public Health. 2007;7:115.
Brown T, Platt S, Amos A. Equity impact of European individual-level smoking cessation interventions to reduce smoking in adults: a systematic review. Eur J Public Health. 2014 Aug;24(4):551–6.
Ravara SB, Castelo-Branco M, Aguiar P, Calheiros JM. Smoking behaviour trends among Portuguese physicians: are they role models? A conference-based survey. Public Health. 2014 Jan;128(1):105–9.
Unim B, Del Prete G, Gualano MR, Capizzi S, Ricciardi W, Boccia A, et al. Are age and gender associated to tobacco use and knowledge among general practitioners? Results of a survey in Italy. Ann Ist Super Sanita. 2013;49(3):266–71.
Baltaci D, Bahcebasi T, Aydin LY, Ozturk S, Set T, Eroz R, et al. Evaluation of smoking habits among Turkish family physicians. Toxicol Ind Health. 2014 Feb;30(1):3–11.
Abdullah AS, Stillman FA, Yang L, Luo H, Zhang Z, Samet JM. Tobacco Use and Smoking Cessation Practices among Physicians in Developing Countries: A Literature Review (1987–2010). Int J Environ Res Public Health. 2014 Jan;11(1):429–55.
Principe R, Paone G, Damante S, Fuselli S, Palermo P, Marchis LD, et al. Implementation of smoking ban: a survey in a public hospital setting. The European Journal of Public Health. 2014 Jun 1;24(3):469–71.
Nagelhout GE, de Vries H, Boudreau C, Allwright S, McNeill A, van den Putte B, et al. Comparative impact of smoke-free legislation on smoking cessation in three European countries. Eur J Public Health. 2012 Feb;22 Suppl 1:4–9.
Fichtenberg CM, Glantz SA. Association of the California Tobacco Control Program with declines in cigarette consumption and mortality from heart disease. New England Journal of Medicine 2000;343:1772–7.
Callinan JE, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. In: Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd; 2010
Masanotti G, Briziarelli L. Workplace health promotion in the context of public health. Italian Journal Public Health - Year 8, Volume 7, Number 42, 2010.
Masanotti G, Briziarelli L. The evolution of workplace health promotion in Europe: the Italian case. Journal of Preventive Medicine and Hygiene. 2006 Jun;47(2).
Masanotti G. The worksite as an asset for promoting health in Europe. Final results of the MoveEurope Campaign. Ig Sanita Pubbl. 2014 Mar-Apr; 70(2):185-96.
World Health Organization. Healthy workplaces: a model for action: for employers, workers, policymakers and practitioners. Switzerland: WHO, 2010.