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?
So where are you going with this? Because I'm agreeing with you. You should not have to be subjected to other people's smoke. There is not much we can do about patients who come in, and unfortunately that will probably always be an issue. But I think there is a lot of room for improvement with coworkers, from what I have read on this thread.
Having discussions like these raise awareness, all the way around. I'm sure there are smokers out there reading this thinking, "geez, I didn't know people felt so strongly about it" ... or "wow, is it really THAT noticeable?"
And I'm saying to those people: Invest in a nicotine replacement for your work days. Seriously. It can be done.
I am also just trying to shed some light on the issue for those who haven't been there. I know that there are deep thinkers out there who will ponder it, and maybe it will have a small impact. I also know there are some who will cross their arms, dig their heels in, and refuse to budge on their stance. That's ok, too. I chose to post anyway. We all bring different experiences to the table, and if yours have been such that you literally can have zero compassion for any smoker, anywhere, regardless of what they've been through or how conscientious and compassionate they are -- then there is nothing that anyone on an Internet forum can do to change that perspective. I sincerely hope that things get better for you. Have a great weekend!
I think you can be pissed off about having to be subjected to it, while still having compassion for the people who struggle with the addiction. If you are one of those who says you have no compassion, I encourage you to just give up your favorite food, or your coffee, FOR LIFE. Just do it. You'll find it's not so simple ... there are all sorts of emotions wrapped up in that food or that coffee, not to mention the effect it is having on a physiological level.
I have loads of compassion for people who are struggling to quit. I'll be their biggest cheerleader. I have zero compassion for those who have no intention of quitting and are inconsiderate and selfish as they participate in their addiction with no concern for the affect it has on others.
Specializes in Peds, School Nurse, clinical instructor.
I do have compassion for people addicted to cigarettes. It is a powerful addiction and very difficult to overcome. That being said, I do not feel it belongs anywhere in the workplace, especially health care. I do agree, smokers take more breaks, I know, I was one. To be honest, I truly did not think I smelled bad until I quit and was able to truly smell it on other people. I try not to preach to people about quitting. Smokers know all about the health risks. People will never be able to quit until they are 100% ready to quit. Just my 2 cents :)
Specializes in Palliative, Onc, Med-Surg, Home Hospice.
And it closes off my airway, period.
I think I get where you are coming from. I just got discharged from hospital after spending 6 days for a life threatening asthma attack. It's NOT about the smell. I know I don't have to smell anything for it to trigger an attack in me.
Unfortunately, I don't think that non-asthmatic (and even mild asthmatics) can get it. Until someone has been in a situation where they absolutely CAN"T take in another breath, where they can't exhale enough to make room for more air, they can only try. I don't fault them for that. I actually told my sister to be grateful that she doesn't understand. But it does get frustrating when someone acts as though they completely understand.
Have you heard the breathing through a straw analogy? My sister did that, she tried breathing through a straw and lasted all of 2 to 3 minutes. I then told her that what she really needed to do was duct tape the straw to her lips and try breathing like that for 2 to 3 HOURS> I think she got an inkling but admitted she would never quite get it. (It was actually refreshing)
I'm sorry that you are going through this horror movie of a disease. (That's how I explained asthma to a cousin of mine; You're living in a horror movie you can't get out of!) And know that at least one person here understands!
I am a smoker, however I was able to quit cold turkey once I found out I was pregnant, because it wasn't just about me then, it was about my baby... then shortly after she was born, I started up again, though I definitely smoked much less than I used to. Once I was pregnant with my second child, I again quit cold turkey, and even stayed off the smokes for 5 years...
It wasn't until I started nursing school that I felt triggered... I picked the habit back up due to the stress and I still smoke now, because nursing=stress.
I plan on quitting again someday... when I am no longer a nurse... because honestly, I don't think I can do this job without smoking....
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!!!
No need to beg - just look me up. Fantastic post right here! I am the pariah of modern society and my addiction truly outweighs the shame.
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37changes, ASN, RN
383 Posts
So where are you going with this? Because I'm agreeing with you. You should not have to be subjected to other people's smoke. There is not much we can do about patients who come in, and unfortunately that will probably always be an issue. But I think there is a lot of room for improvement with coworkers, from what I have read on this thread.
Having discussions like these raise awareness, all the way around. I'm sure there are smokers out there reading this thinking, "geez, I didn't know people felt so strongly about it" ... or "wow, is it really THAT noticeable?"
And I'm saying to those people: Invest in a nicotine replacement for your work days. Seriously. It can be done.
I am also just trying to shed some light on the issue for those who haven't been there. I know that there are deep thinkers out there who will ponder it, and maybe it will have a small impact. I also know there are some who will cross their arms, dig their heels in, and refuse to budge on their stance. That's ok, too. I chose to post anyway. We all bring different experiences to the table, and if yours have been such that you literally can have zero compassion for any smoker, anywhere, regardless of what they've been through or how conscientious and compassionate they are -- then there is nothing that anyone on an Internet forum can do to change that perspective. I sincerely hope that things get better for you. Have a great weekend!