More on Matt's pet cause:

[mattcastens]

From an editorial in the March issue of the American Journal of Critical Care, by Ruth E. Malone, RN, PhD:

Every week, 52 weeks a year, some 8000 people in this country die from tobacco-related diseases, their lives ended prematurely by an aggressive tocacco industry and the addictive properties of nicotine. ... The total: more than 4000,000 premature deaths yearly in the United States and 3 million worldwide. Among the dead will be many nurses, providing evidence that mere knowldege -- even firsthand knowledge -- about tobacco's harmful effects on health is not enough to prevent them.

Although most nurses are nonsmokers and there is eveidence that many nurses have quit during the past 2 decades, smoking rates among nurses (18.3% for registered nurses, 27.7% for licensed practical nurses) are still far higher than those for physicians (3.3%), and nurses' rates of quitting are lower than physicians' rates. Some evidence indicates that smoking my be more common among nurses in critical care specialty areas and psychiatry than among nurses in women's health, pediatric, and general practice areas. ...

There is nothing about nursing, medicine, or any other health profession that intrinsically renders its practitioners immune from [the] barrage of social messages, crafted by the best marketing minds money can buy and insinuating themselves into so many aspects of our social fabirc. ...

The tobacco industry first began targeting women during the 1920s and 1930s. From the 1940s through the 1970s, this effort increased dramatically, and women (including nurses) took up smoking in greater numbers than before. In fact, nurses and physicians were important figures in tobacco marketing from the 1930s through the 1950s, and era in qhich the industry sold cigarettes by making health claims about their products: that they were 'less irritating to the throat,' that 'more doctors' smoked them; and that they were 'fresh,' suggesting wholesomeness and 'hygiene'. Advertisements during this period featured clinicians in medical or nursing dress and settings, and the ads themselves appeared regularly in professional publications, including the American Journal of Nursing, suggesting links between smoking and good health, despite the fact that the first studies linking smoking with lung cancer had appeared at least a decade before. ...

At the patient care level, nurses who smoke have been shown to be less effective in cessation/prevention counseling and may be less effective as role models for their patients. In the public policy arena, the absence of a major nursing presence among those advocating for strong tobacco-control measures and attention to the role of the tobacco industry is regrettable, particularly considering the trust in which the public holds nurses as a group. For example, a recent study of people's reactions to viewing The Insider, a film about the deceptive activities of the tobacco industry, asked subjects to rate people in a list of professions on 'ethics and honesty' and on 'power.' The list included polititian, movie director, nurse, tobacco industry executive, scientist, TV reporter, and multinational food company executive. Nurses received the highest mean rating, and tobacco industry executives received the lowest mean rating for 'ethics and honesty.' Disconcertingly, however, 'nurse' was ranked lowest on 'power,' while tobacco industry executive was second in power only to 'politician.'

Regarding this perception, one issue warranting furthur thought within the profession is that nurses have invested considerable political capital in getting access to 'inside' political channels through professional organizations and political action committees. However, nurses have not, as a group, developed major 'outsider' advocacy in terms of tobacco or, arguably, in terms of public health issues more generally -- stratagies that would increase the nursing's public visibility and power. In the area of tobacco-control policy, 'insider' stratagies have been shown to be considerably less effective than 'outsider' advocacy stratagies that draw public and media attention to the issues. It is intriguing to imagine what attention even small groups of highly committed nurses might bring to tobacco issues -- and to nursing -- if they began showing up at tobacco company stockholders' meetings, challenging industry-backed legislation through well-placed editorials, or demonstrating at tobacco-sponsered events.

Today, though many policy statements have been issued and nurses are well aware of the harmful effects associated with tobacco use ... nurses are not, as a group, especially vocal in advocating for tobacco-control measures or challenging the industry's tactics, nor are they active in conducting tobacco-control research -- with a few stellar exceptions. Yet, if mobilized, nurses 'could easily become formidable opponents for the tobacco industry,' in the words of one tobacco industry executive. Nursing's strategic advantage lies in the trust the public places in the profession. Publicly confronting the tobacco industry and working on multiple fronts to end the tobacco epidemic could bring nursing back in touch with its public health origins and the grassroots sources of nursing's true power.

What would it take to mobilize nurses? First a comprehensive effort is needed to help allnurse quit smoking. This means not merely offering cessation programs tailored to the needs of health professionals, but broader measures in schools of nursing, professional organizations, and across public spheres (including strong clean indoor air policies) so that smoking becomes socially undesired.

Second, support for organizing locally based, grassroots campaigns that call attention to the ways in which the tobacco industry continues to market disease and death in attractive disguises could stimulate nurses to action. ...

Finally, nursing must develop its vision and extend its concerns beyond helping patients cope with tobacco-related suffering, important though this is and will continue to be. This means recognizing that caring is always a political act and understanding that nursing's untapped political strength lies in advocacy. But doing this will mean imagining a world where 8000 undeserved, preventable deaths in 1 week will shock us.

Comments welcome and encouraged.

[fergus51]

3.3% of physicians? I am shocked, I thought it was way higher!

[Jenny P]

Matt, at last years' MNA convention there was a silent auction with $$$ being raised for MNA-PAC. One of the items being bid on was a grooup of AJNs from the 50's. There they were: those ads about smoking in a nursing magazine! And they DID say things like "less irritating to the throat" or "the menthol soothes".

I agree with you 100% about smoking; but I can't MAKE anyone else stop-- except when they are around me (I have asthma). My own son smokes, and as long as I've tried to "harp" at him, he wouldn't stop. It is only this past week, after I hadn't mentioned it, that he told me that he was trying to quit because of a chronic cough. Now I pray that the cough is nothing to worry about! :)

[mcl4]

[

What would it take to mobilize nurses? First a comprehensive effort is needed to help allnurse quit smoking. This means not merely offering cessation programs tailored to the needs of health professionals, but broader measures in schools of nursing, professional organizations, and across public spheres (including strong clean indoor air policies) so that smoking becomes socially undesired.

I pretty well thought society has already imposed clean indoor air policies as well as making smoking socially undersirable.

Second, support for organizing locally based, grassroots campaigns that call attention to the ways in which the tobacco industry continues to market disease and death in attractive disguises could stimulate nurses to action. ...

With all the class state and federal lawsuits, I believe most people are aware of tobacco companies deceptive means of advertising or marketing their product.

Finally, nursing must develop its vision and extend its concerns beyond helping patients cope with tobacco-related suffering, important though this is and will continue to be. This means recognizing that caring is always a political act and understanding that nursing's untapped political strength lies in advocacy. But doing this will mean imagining a world where 8000 undeserved, preventable deaths in 1 week will shock us.[/b]

Comments welcome and encouraged. [/b]

I tend to think the lawsuits by individuals and states against the tobacco companies have brought the greatest attention to the dangers of smoking. States winning large sum of money from the tobacco companies with details about their cases are well publicized in the print and televised news programs. I also find it difficult to believe that an individual who smokes isn't aware of the harm this does to their health.

[mario_ragucci]

I should keep my mouth shut, but thats not cool, is it. :-) All of your information is correct Matt, and I agree. Everyone knows this information. Really. The deaths, the problems, the prevalence, etc.

Tobacco smoking has been an American custom for hundreds of years.

If we/you want to stop this, it would take more than mobilizing nurses. It would take stopping cigarettes, and I am with you. Perhaps it would take several thousand people who would not be afraid to attack, and destroy, cigarette factories. Right? Logically, since people are dying left and right from tobacco, it would make sense for some to give their life so that others can live.

Remember when they stopped drinking, and they destroyed all the booze? Remember when they stopped pinball, and they destroyed all the pinball machines?

As long as cigarettes are legal to purchase, all this talk about stopping nurses from smoking is ineffective. The whole ball of wax must be turned. That would take some sacrifices of life, not just education. Everyone knows it's "not a good thing" to breath in smoke.

Again, you would need to mobilize folks who are not afraid to throw their lives on the machines that produce cigarettes. It would take MUCH MORE than raising awareness.

[RNforLongTime]

Hi Matt,

Did you know that we have the same birthday? Except you are 0ne year older than me! Hee-hee!

[mattsmom81]

We are simply not going to stop addiction in another person.

The addict must want to stop and he/she decides that.

I'm thankful to live in an area where indoor smoking is prohibited except in special ventilated areas in bars.

Discontinuing cigarettes will only place them on the black market.

I dislike the odor, the cough, the film on the windows,AND the health risks. Wish more people would quit too (especially health care professionals) but they tire of our lecturing and just tune us out....so "live and let die" will be the smokers' motto in spite of us, I'm afraid.

Oh and have you noticed smoking is 'way cool' on TV again now?

[mario_ragucci]

Originally posted by mattsmom81

Discontinuing cigarettes will only place them on the black market.

Damn! I didn't think of that! Your right! But, AMerica having oceans on each side, it would be very tough to get cigarettes, and certainly cut it out.

I was thinking more along the lines of several "surface to surface" missles (with Red Crosses on them) launched at the major factories....followed by ground troops to ensure the destruction of the machines. Nice thought, right. :-)

In Australia and New Zealand people smoke alot less because they don't have a ga-zillion brands like they do here in the states. Education is not going to prevent folks from smoking. The real Americans, back in the 1770's had the right idea with the boston tea party. Things have changed since then, but the idea is the same.....reject the crazy addiction (to england). In present day america, people are very complacent (sp)

[VickyRN, MSN, DNP, RN]

I'm afraid it's a little more involved that "live and let die." Besides the unbelievable suffering cigarrette smoking inevitably produces, WE ARE ALL PAYING FOR THIS HABIT, whether we smoke or not. Why are insurance premiums so high???? Cigarette smoking is a BIG reason, one we're ALL HAVING TO PAY.

[JMP]

I just read an article yesterday, written by a RT about this very topic.

Her name is Anne Landman. As a RT she estimates that 95 percent of her pt load is smoking-related. Her quote "when I see someone smoking, I see someone dying".

After the large settlements, Landman has spent hours of leisure time at her computer- she lives in COlorado, sifting through tobacco industry documents and unearthing things that have outraged her. You see in the 1998 Master Settlement, it forced tobacco companies to post publicly 36 million internal documents.

What she found out was TERRIBLE. The companies are trying to find ways to get kids to smoke. One document read " Imagine a five-year-old who will be a future customer, how can our company BEGIN to attract or tap into this next generation".

In early 1999 Landman made a discovery. THe tobacco companies where paying "placement fees" to retail stores for self serve displays. The displays where within reach of children, but out of sight of the clert, thus enabling shoplifting and by extension, nicotine addiction.

I could go on and on about his the article was quite long. However I will include ways for you to link to the documents if you so wish:

Phillip Morris: http://www.pmdocs.com

Brown & Williamson: http://www.bwdocs.com

If you want to look at the documents Anne Landman has collected and summarized, or to subscribe to her doc-alert list go to:

http://www.smokescreen.org

Landman now spends time presenting to adults and children, focusing on the documents she has culled. "I want the people who use the product,or who are exposed to it, to know what is in this stuff, what they are taking into their bodies........Think about it. Tobacco companies don't have to provide a listing of the their products, but SHAMPOO companies do. You wuld need a permit to dump the toxins into a land fill that are contained in cigarettes. Benzene, orificenic, ammonia, formaldehyde, hydrogen cyanided- STUFF they use in the gas chamber".

I know this post is long, but important, I thought. It is my Pet cause as well. Education, it is the key.

[JMP]

Oh Yeah........Mario

Here are the rates of smoking for the countries you are talking about:

Australia- 27% of men smoke, 23% of women smoke

USA- 28% of men smoke, 23 % of women smoke

Canada- 31% of men smoke, 29% of women smoke

I live in Canada, we have access to tons of types of cigarettes. Your statement regarding down under is just not true. Get the facts Jack.

[JMP]

So many of the nurses that I know, who do smoke, tell me it is stress related. I work in ICU and the stress level can be high. This seems to me to be the point that so many nurses break down at. They try to quit, but then face a wall of stress and HAVE to GO OUTSIDE for a break and then........ well you know what then.

Could an effective stradegy be devised for nurses, with stress reduction a large part of it. Let's face it, they know the bad stuff about smoking, but many are in denial. Could the stradegy be about giving the stressed nurses something ( no, not a donut) other than smoking to deal with the stress. I am trying to study for a pulmonary exam later today, BUT keep thinking about this subject. I am just blue-skying here, but what if there was a place to go, other than the butt-hut, a way to deal with the stress in small increments?? Let me think about some more........ I mean we can't just give up!