Doctors and nurses in New Zealand are smoking less, and this bodes well for Smokefree 2025, says a study published today in the New Zealand Medical journal.

The University of Otago, Wellington (UOW) led research examined recent smoking trends among doctors and nurses in New Zealand by comparing data from the 2013 Census with that of 2006.

Professor Richard Edwards

Lead author Professor Richard Edwards from the Department of Public Health at UOW says the findings illustrate that New Zealand’s Smokefree 2025 goal can be achieved among health care workers – doctors are already there, and generally nurses are well on the way.

“It is very good news to see doctors’ and nurses’ smoking reduce so dramatically. It is important because they are very credible non-smoking role models for their patients and the wider community, but also because by being a non-smoker it probably enhances the likelihood that they will provide encouragement and support to smokers to quit.”

The 2013 census included 7,065 male and 5,619 female doctors, and 2,988 male and 36,138 female nurses. In 2013, two per cent of male and female doctors and nine per cent of male and eight per cent of female nurses were regular cigarette smokers. This compared with four per cent male and three per cent female doctors, and 20 per cent male and 13 per cent female nurses in 2006.

The 2013 doctors’ smoking rate of two per cent was well under the Smokefree 2025 goal of five per cent but smoking was still above the goal for nurses, particularly mental health nurses (15% men and 18% women). Smoking among both Māori doctors (7%) and nurses (19%) was higher.

Higher rate for mental health nurses historic

Director, Smokefree Nurses Aotearoa/New Zealand Dr Grace Wong said she is pleased with the results of the study.

“Both Māori nurses and mental health workers are smoking at a lower rate than Māori in the community and mental health consumers in the community.”

She explained that there is a lot of research into why mental health nurses smoke at a higher rate compared to other nurses. For example, she said, staff in mental health institutions did use to interact with patients by smoking for a variety of different reasons.

“One of those was when you had someone who was agitated and wanting a ‘cig’  – the thinking was in those times was that (smoking with them) was a way to calm them down.”

“Overall we have found the reasons our nurses give for stopping is reflective of the wider community in that their primary motivations for stopping smoking was for their health and for their families.”

Workplace interventions may work

Targeted workplace smoking cessation support may be an efficient means to reduce smoking among key occupational groups, said Dr Edwards.

“These findings suggest that an important intervention to help reach New Zealand’s Smokefree 2025 goal is to provide some extra encouragement and support to quit for health care workers who are still smoking. For example, we could explore the needs of Māori nurses and psychiatric (mental health) nurses who smoke and develop supportive interventions to help them to quit.”

However the authors of the study urged caution around expecting similar results from smoking cessation programmes for all groups.

It said that doctors are a highly educated, high status, high-income group and such a low smoking prevalence may not be achievable in more marginalised groups without much more substantial tobacco control and smoking cessation interventions.

The study noted that doctors and nurses who don’t smoke are more likely to provide smoking cessation advice and support than their smoking colleagues.

And that a possible reasons for this is that nurses and other para-professionals who smoke experience ‘dissonance’ as they know as health professionals they should be role modelling health-promoting behaviours.  The study said that dissonance  – or conflict between their personal and professional behaviour – may inhibit nurses who smoke from providing smoking cessation advice to patients and potentially to wider family members.

Evidence also suggested the credibility of smoking cessation service delivery may be undermined if the provider is known to be a smoker.

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