Nurses and cigarette smoking: a literature review.

This brief literature review covers forty-eight references from the English-speaking world and is concerned with three subject areas or questions, which are: In what way are nurses heavy smokers? What particular aspects of nursing may cause nurses to smoke? What influence does a nurse's smoking behaviour have on the effectiveness of the use of nurses in health-education campaigns specifically designed to decrease smoking? The first part of the article critically examines the assumptions underlying some of the evidence which has already been collected on the question of nurses' supposed heavy cigarette-smoking consumption. The general point which is made is that few of the social-research studies concerned with nurses' smoking behaviour seem to be correctly focused. The second part of this review is concerned with some of the issues which may need to be clarified. For example, it is proposed that a distinction should be made between the starting, continuing and stopping of cigarette smoking. Similarly, it is argued that nursing cannot account for the cigarette-smoking behaviour of nurses who begin nursing as smokers, nor (obviously) for those who never smoke. It is therefore suggested that the emphasis of research could initially be on those who become cigarette smokers while they are becoming nurses. Finally, having accepted Farrell's definition of health education as only including information-giving, and not behavioural changes, it is argued that any ideas of the use of nurses as health educators in smoking-cessation work in hospitals will need to be clarified and translated into practical and sensible options which take account of the limitations within the nurse training process, and also the heavy work load of nurses.