In this article the author goes over some of the reasons nurses continue to smoke and urges a compassionate approach with an encouraging touch toward all who struggle with habits that are hard to overcome.
My friend excused herself after a long meeting. I knew where she was going - to the cold parking deck, to get in her car, to have a cigarette, to still her craving so she could get back to work and concentrate on her job.
If you have watched any movies about the 1960's lately, you probably realize that many fewer people smoke now than did at that time. In '65, a little over 40% of the population smoked (including large numbers of health care providers!) and now a fewer than 15% do (Center for Disease Control and Prevention)."Recent declines in smoking among health care professionals may reflect the impact of national tobacco control policies and efforts focused on reducing smoking among registered nurses. After little change in prevalence from 2003 to 2006-2007, the drop in smoking among registered nurses was more than twice that of the 13 percent decrease in the population." (Study Examines Prevalence of Smoking Among Health Care Professionals - For The Media - JAMA Network) While there is encouraging news, smoking in the general population and among nurses remains a commonplace occurrence.
Most of us have friends who smoke, nurse friends, co-workers, and others. Smoking or not smoking is a touchy topic and just bringing it up makes people want to go to different sides of the room, flinging hot, angry flaming arrows at one another. While we all have opinions, and those opinions matter, especially in the face of compelling evidence, we do ourselves and others a disservice when we retreat and point fingers at each other. How can we keep reaching out to each other, being patient and compassionate no matter what our particular challenges are?
Bad habits are notably hard to overcome and substance abuse, including addictions to nicotine, can be particularly noisome. For anyone who has any type of bad habit-most of us have at least one-we know how hard it is to overcome. Listing all types of bad habits here will not help us proceed in our conversation for as humans we automatically want to compare our bad habit to smoking and say-"Well, mine isn't THAT bad." Maybe not. But let's all admit that it's pretty hard to compare bad habits and it's even harder to cease a bad habit. Our tendency to look at others' faults with less compassion than we look at our own is pretty universal and sadly also difficult to overcome. Myriad studies have been done on overcoming the compulsion of bad habits and no matter how you look at them, they all say the same thing: giving up a bad habit is hard work and relapsing is as easy as taking a puff or two.
So first, how can we cultivate an attitude of grace and compassion toward members of our profession who continue to struggle with an addiction to nicotine? One thing that might help is to realize that we are all susceptible to the clinging effects of our own vices. Being honest with ourselves and vulnerable to one another, we take the first step in reaching out to a friend who is struggling with support and care instead of judgment and condemnation.
It's hard for people who are not addicted to nicotine to fully understand its effects and the pervasive reach it has throughout smokers' lives: home, travel, work, entertainment-all can be powerful influences in keeping a person tied to their habit.
Long-term smokers may have linkage behaviors or triggers that contribute to the continuation of the habit-things like group smoking, an association between a morning coffee and a cigarette, alcohol, good feelings perceived to be related to smoking, less anxiety, even daily bowel rituals.
The process of withdrawal can be scary for some-especially if they have gone through it before-and lead them to put off the day they quit.
Nicotine increases dopamine levels and produces a temporary feeling of well-being, of less anxiety and of increased concentration, all reinforcing the behavior and keeping smokers coming back for one more. While these perceived benefits are small and time/dose limited, quitting to "normalize" the body's equilibrium can be daunting for some.
Defiance of established norms or expected behavior-For a variety of reasons, people sometimes continue to smoke to defy societal expectations. There are times when society can be perceived as imposing a veritable straitjacket of limitations and guidelines, leading some to throw up their hands and disregard some of the more basic cautionary information, including the tsunami of information about the dangers of nicotine.
Concerns about weight gain- Weight issues may seem to pale in comparison to the side effects of smoking but this is a real concern for many.
With great sadness, a physician friend once pointed out ruefully, "I have had some success in encouraging people from all walks of life to quit-including some nurses. But at other times, I have failed. I wish that more times I had pointed out that the real danger of smoking is not dying, it is actually continuing to live in the face of the limitations that long-term addiction invariably imposes on the human body. In the end, people wish they could die."
Smoking is a bad habit. No doubt about it. But maybe we can find ways to offer each other more compassionate support and less judgment. How can we be a force of encouragement to our peers?
I kind of disagree with their right to do what they want with their own bodies- We are all paying for it.
If all we did was provide palliative care for addicts, then maybe. But, no matter what health care policies exist, we all share the cost on this one.
Totally agree. But let's forget about this for just now :)
One NM I once worked under made a rule that whoever sends fellow nurse, CNA or RRT in ER by exposing them to things they made known to be allergic to had to take his or her full assignment within scope of practice to the end of the shift. We had quite a few bad asthmatics and a couple of them with severe allergies as well. The question of staff smelling like tobacco barn and peanuts strewn around nursing station disappeared after just one case when this rule was applied for real.
I don't smoke now (pregnant) but I did from the age of 14 until my mid twenties. I felt like the biggest hypocrite telling patients "smoking can bring this on. Please consider quitting" then going outside to light up.
Without saying anything directly about those who still smoke, nurses or not, here's my own & family experience. My parents were great, but they both smoked, which wasn't too unusual in their generation. My brothers and I all smoked too, although one brother and I quit by 30. Emphysema took Dad, lung cancer took my oldest brother, and I'm sure smoking & second-hand smoke is why I had bladder cancer at 40 & 42 (but thankfully - VERY thankfully - nothing since then). An aunt never smoked but her husband, my uncle, was a chain smoker, and she was on oxygen toward the end. I'm so asthmatic when it comes to smoke exposure that in recent years, an exposure of 10 seconds can make me feel crappy for days - and I'm not exaggerating whatsoever (so working home health has never been a possibility for me). And oh yeah - a sister-in-law (long-time smoker) had lung cancer, had surgery, and is thankfully still with us.
This is a subject near and dear to my heart. I'm an ex-smoker who is also a nurse. I'm doing my CAPSTONE project on nurse smoking and the impact on nurse careers and patient relationships. Soon I will be begging nurses who smoke on this site to take part in my study. Anyway, if we look at cigarette smoking as an addiction then we should try treating it as such. Dispersions and harsh judgements never cured any patient from any disease process that I know of including addiction. Further, smokers already know they are pariahs of modern society especially if they work in healthcare. Their addiction is simply stronger than any sense of shame that can be put on them by other nurses. Have a great night all!!!
Agree. I'm sorry they have an addiction, but I'm very sensitive to smoke, and if the smell is strong enough, I have trouble breathing. I have many coworkers who smoke, which can make working near them difficult when they've come back from one of many smoke breaks (and why do they get more breaks than I do, just because they need to smoke?)
Whatever do you do when you have the patient room with visitors who reek of smoke?
Specializes in LTC, assisted living, med-surg, psych.
I carry an albuterol inhaler with me in my purse everywhere I go. I developed asthma AFTER I quit smoking (oh the irony!), and cigarette smoke is one of my major triggers. Even now, I can hardly stand to go into a casino or anyplace where people are smoking; I end up coughing and wheezing for hours afterwards. And boy, does it STINK...I never realized when I was smoking how bad I smelled. It seeps into everything. I remember moving to a new house and going through some things I hadn't seen in awhile, and even then I could still smell the smoke in my old clothes. I'm so glad I was forced to stop.
I am an occasional smoker. I never walk away from my duties to light up and I do not need to smoke prior to my shift. I do no smell like smoke at work. I understand others are sensitive and respect it. No one knows I smoke either.
But I hope others can understand if I find heavy perfume or hand lotion (cucumber melon especially) very offensive. These items will really make my sinuses burn.
I am a former smoker and I have all kinds of compassion for those who struggle with that addiction, It took me many years and numerous tries to quit but I finally did it. Like others who have quit my lungs strongly object to smoke and/or smell now and being in a closed exam room with a smoker about does me in. I work for a "fragrance free" organization. Which means no strong smelling perfume, hand lotion or the smell of cigarettes is permitted and it's nice not to have to deal with the smell at work. But when they instituted this policy many went to vaping instead so no real progress was made to quit.
I tried quitting four times, and I only lasted a few weeks before going back to the evil weed. I was young at the time, but I was sick with breathing problems so often that more than one doctor told me I wouldn't live to age 40 if I kept smoking. That was enough to scare me off cigarettes for a couple of months, but I always went back. It was only when I got pregnant with my last child that I finally managed to quit for good, and even then it wasn't on purpose---the smell of cigarette smoke made me ill. I just never picked up again after that, and I've now been smoke-free for over 27 years.
So I tend not to be too judgmental of healthcare workers who smoke. I know what it's like to have a nicotine fit and I'm glad I don't go through that anymore, but it's not a moral failing if one simply can't quit cold turkey. A lot of people are in the position of "wanting to want to" quit, they're just not quite ready to give it up yet. I remember the tough part for me was the psychological dependence I had on cigarettes; I liked holding them, lighting them, the feel of them in my mouth. What helped me to break the habit was cutting drinking straws into cigarette-sized pieces and drawing in air just like if I was puffing on a smoke. Occasionally I forgot and lit one, or I'd find myself tapping the end in the ashtray. But it did help reduce the craving, and eventually I stopped that too.
Has anyone else read about smoking as a way of "self-treating" for mental health issues? I have heard it is why the VA continues to allow veterans to smoke on VA campuses. I wish we could find a way to safely deliver the nicotine that calms the nerves of folks with anxiety and PTSD...what I really wish is that we spent more time, money and energy on mental health issues. Thank you for posting - anytime I see someone encouraging compassion, I am grateful. We need more positivity and love in the world.
Thank you for your kind comment. When we step back, we remember that it is easy to condemn but harder to be constructive and supportive. I hope that we can serve as an encouragement to one another as we all struggle with our very own troubles. Joy
That is becoming more the norm. In fact in some parts of the country employers are allowed to fire employees if they are found to be smokers. Nurses have made great progress in smoking cessation but in some specialties smoking rates remain high (ER, Behavioral Health & LTR come to mind). Anti smoking has taken a decidedly aggressive stance
KatieMI, BSN, MSN, RN
1 Article; 2,675 Posts
Totally agree. But let's forget about this for just now :)
One NM I once worked under made a rule that whoever sends fellow nurse, CNA or RRT in ER by exposing them to things they made known to be allergic to had to take his or her full assignment within scope of practice to the end of the shift. We had quite a few bad asthmatics and a couple of them with severe allergies as well. The question of staff smelling like tobacco barn and peanuts strewn around nursing station disappeared after just one case when this rule was applied for real.