"In the current climate of disease prevention and health promotion, smoking behaviors of future physicians and nurses have become increasingly important," said lead author Ashwin A. Patkar, MD, Department of Psychiatry and Human Behavior, Jefferson Medical College, Philadelphia, PA. "Physicians and nurses can significantly influence health-related behavior of patients. However, health-care professionals who smoke are at a particular disadvantage when attempting to impact their patients' smoking related diseases and are less likely to positively influence their behavior."
Researchers from Jefferson Medical College at Thomas Jefferson University in Philadelphia investigated the smoking habits of medical and nursing students enrolled at the university and examined whether smoking habits changed during the course of education for each group. Medical and nursing students completed anonymous surveys containing questions on graduating class year and demographics, and the Fagerstrom test for nicotine dependence (FTND). Surveys were completed by 397 medical students (212 women and 185 men) and 126 nursing students (105 women and 21 men). Survey results revealed that 13.5 percent of nursing students smoked cigarettes, as compared to 3.3 percent of medical students. In addition, 17.4 percent of nursing students and 9.8 percent of medical students considered themselves former smokers. Average smoking rates in the general population are estimated at more than 25 percent, while studies conducted in the 1990s indicated a 15-25 percent smoking rate in nursing students and a 2-10 percent smoking rate in medical students. Of the students who smoked, 89.7 percent of nursing students were women, as compared to 57.6 percent of medical students. Female smokers in both groups had a higher FTND score than male smokers and reported smoking more cigarettes per day, more often, and sooner after waking up in the morning.
"The decrease in the number of medical students smoking cigarettes is encouraging. It seems that the decision to begin training to be future doctors may make medical students more aware of the need to quit in order to appear as good role models to patients and the public," said Dr. Patkar. "Gender differences could partially explain the smoking variations between medical and nursing students, but nursing students may also be less aware of their role and responsibilities to provide smoking cessation treatment than medical students."
When smoking habits were compared across class years, no differences were found in the number of smokers or former smokers, mean FTND scores, and immediate plans to quit. However, in medical students, the mean time since quitting was 1.6 years for the first-year medical class, 2.4 years for the second-year class, and 3.5 years for the third and fourth year classes, leading researchers to believe that former smokers may have quit within 12 months before entering medical school. No such differences were observed among former smokers in nursing school.
"As health-care providers, we have the responsibility to our patients to model a healthy lifestyle, including abstaining from tobacco use," said Udaya B. S. Prakash, MD, FCCP, President of the American College of Chest Physicians. "Medical and nursing schools can encourage this healthy lifestyle by offering tobacco cessation services for students and educational programs that will help prepare future medical professionals to counsel patients who smoke."
CHEST is a peer-reviewed journal published by the ACCP. It is available online each month at www.chestjournal.org. ACCP represents more than 15,700 members who provide clinical respiratory, critical care, and cardiothoracic patient care in the United States and throughout the world. ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication.