Are nurses who smoke guilty of setting a bad example?

It’s ten years, perhaps more, since I stubbed out my last cigarette. It is difficult to remember now just how socially acceptable smoking was in the recent past. In my early days as a nurse, only two decades ago, my tea breaks were spent in the ward sister’s office in a fog of first and second-hand smoke, and we were oblivious to the noxious impression we gave our patients as we went back to work.

In the time since I quit, cigarette smoking has become one of the great public health stories of recent times, with ever-shrinking furtive groups of smokers congregating sadly in outdoor corners. That is the popular image – but is it truth, or myth?

A recent BBC TV programme, Burning Desire reports that tobacco companies are in rude health – which is perhaps more than you can say for most long-term smokers. Anecdotally, it seems to me smoking is creeping back into public view, and there have been newspaper reports that rates are rising in children and younger adults.

Perhaps smoking has never gone away. The rise of the electronic cigarette (e-smoking) has been a shot in the arm for the tobacco industry, not just because it provides sales opportunities for nicotine-related products. Recent debates on bringing e-cigarettes into the remit of the medicines and healthcare products regulatory agency raise the profile of smoking in the media, which is a real boon for marketeers.

Hospitals, according to NICE, should be setting a good example. But a recent article in Nursing Standard reports that many are considering the re-introduction of smoking ‘shelters’. This is because an outright ban on smoking in hospital grounds seems to be unworkable. Sadly, this seems to reflect not only patients’ behaviour but also that of nurses and other healthcare professionals.

Nurses have always smoked, but do they do so any more than the general public? Much of the literature on smoking relates only to providing health education and cessation advice. There is perhaps an interesting study to be done on nursing smoking rates and whether they have declined in recent years – evidence from the US suggests they may have done.

Such a study might raise some interesting questions on how nurses perceive their roles in public health. As a young(ish), newly qualified staff nurse I had no interest in such issues. I was there simply to care for people, so I thought, and the irony of working with desperately ill people while reeking of cigarette smoke was easy to brush off.

It is difficult, thankfully, to exist in such a state of denial these days.

About the author

Ed Rowe trained at St Mary’s Hospital in Paddington, London, in the late 1980s and practised in general surgery. He now works on the Nursing Standard’s art & science desk as a clinical editor. He blogs in a personal capacity about the NHS and health-related issues at http://livesintheirhands.wordpress.com/
Follow Ed on Twitter: @edrowe0