Nurses' perspectives of smoking initiation, addiction, and cessation.
BACKGROUND
It is estimated that 18% of registered nurses smoke. Although nurses can make an important contribution to national cessation efforts, continuing smoking among nurses has been cited as one of the barriers against higher nursing involvement.


OBJECTIVE
To develop a national program to assist nurses in smoking cessation through an in-depth understanding of issues related to nurses' attitudes toward smoking and quitting, and to explore nurses' preferences for smoking cessation interventions.


METHODS
Eight focus groups were conducted in four states with nurses who were current or former smokers. Content analysis was used to identify major themes.


RESULTS
Four themes were identified: initiation of smoking and addiction, myths and misconceptions about quitting, overcoming addictions, and strategies for enhancing successful cessation. Nurses described addiction and cessation efforts similar to those of the general population. However, nurses experienced guilt related to their smoking, and perceived a lack of understanding by nonsmoking colleagues and managers about their need of support for smoking cessation. Nurses who had successfully quit smoking were motivated by health concerns, pregnancy, and their children. Nurses suggested many interventions that would be supportive of their quit attempts, such as worksite services and Internet-based support groups.


CONCLUSIONS
Nurses expressed the need for smoking cessation interventions similar to that of the general population, and for additional support that recognizes two concerns: confidentiality about their smoking in terms of the general public, and support along with counseling with regard to their feelings of shame and guilt in relation to their public image as nurses.
Bialous
Stella Aguinaga
SA
School of Nursing, University of California, Los Angeles, California 90095, USA.
Sarna
Linda
L
Wewers
Mary Ellen
ME
Froelicher
Erika Sivarajan
ES
Danao
Leda
L
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D006167:Guilt; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009042:Motivation; D024802:Nurse's Role; D009726:Nurses / Q000523:psychology*; D015404:Nursing Methodology Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D012657:Self-Help Groups; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D000074606:Smoking Prevention; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States