title: The influence of friends on smoking commencement and cessation in undergraduate nursing students: a survey.
abstract: BACKGROUND
  Smoking is one of the leading causes of morbidity and mortality in most countries. Despite the fact that nurses have an important role in health promotion, and are in a good position to see and reflect on the detrimental effects of tobacco smoking, research has shown that the rate of smoking among nurses is similar to the rest of the population.
  
  
  OBJECTIVE
  The objective of this study was to examine the attitudes and experiences of undergraduate nursing students in relation to smoking commencement and cessation. It was part of a larger study that explored students smoking behaviours, knowledge and attitudes.
  
  
  METHODS
  A non-probability sample of 366 undergraduate nursing students from a large Australian school of nursing and midwifery took part in the study. The participants completed the Smoking and Health Promotion instrument. Ethics approval was obtained prior to the commencement of the study.
  
  
  RESULTS
  Peers and friends were an important influence on the decision to commence smoking. The wish to comply with peer norms was especially prominent in mid-adolescence. Most smokers wanted to cease smoking, and many had tried unsuccessfully to stop on one or more occasions. They conceded that the pleasure they obtained from smoking and the effects of stress acted as barriers to stopping. The participants acknowledged the adverse health effects of smoking and some had already experienced these effects, but neither of these was enough to prompt them to cease.
  
  
  CONCLUSIONS
  Undergraduate nursing curricula need to place greater emphasis on examining smoking related illnesses, as well as health promotion and role modelling in particular. Health promotion strategies that target peers are needed as an alternative to programmes that use fear or appeals to moral authority to prevent individuals from commencing smoking or encouraging cessation.
authors.affiliation: Division of Nursing & Midwifery, La Trobe University, Wodonga VIC, Australia.
authors.forename: Eileen
authors.initials: E
authors.lastname: Clark
authors.forename: Terence V
authors.initials: TV
authors.lastname: McCann
mesh_terms: D000328:Adult; D001315:Australia; D004506:Education, Nursing / Q000458:organization & administration*; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D010379:Peer Group; D012907:Smoking; D016540:Smoking Cessation; D011795:Surveys and Questionnaires