10 Tips to Wake Up in Morning

Abstract and Introduction Abstract

Objective: The approach and credibility of future physicians and nurses as treatment providers for smoking-and tobacco-related diseases may be influenced by their smoking habits. We compared smoking habits among medical and nursing students, and examined whether these habits changed during the course of education for each cohort.Method: Over 1,100 medical and nursing students from a university were surveyed in year 2000 using a questionnaire that included the Fagerstrom test for nicotine dependence (FTND).Results: A total of 397 medical students and 126 nursing students completed the survey. Significantly fewer medical students (3.3%) smoked compared to nursing students (13.5%). Also, significantly more nursing students were former smokers (17.8%) than medical students (9.8%). The severity of nicotine dependence, as indicated by the total FTND score as well as scores on five of the six items on the FTND, was significantly lower among medical students compared to nursing students. Smoking or quit rates did not differ across class years in both groups; however, unlike nursing students, time since quitting significantly differed across class years for medical students. Although smoking habits appear to change little during the course of education for both medical and nursing students, many smokers may have quit just prior to entering medical school but not nursing school.Conclusions: The findings confirm the continuing decline in smoking among medical students in the United States; however, increased efforts to promote tobacco education and intervention among nursing students seem necessary. Nevertheless, both groups appear to have the potential to be credible advisors to patients and public regarding smoking cessation.


Despite extensive data indicating that health-care providers can help smokers to quit, medical and nursing practitioners have generally not been proactive in providing smoking cessation services to patients.[1,2,3] Inadequate undergraduate education about tobacco treatment has been reported to be one of the many factors that may contribute to the missed opportunities by health practitioners to provide effective tobacco-treatment interventions to their patients.[4] In an attempt to improve the participation of health-care providers in smoking cessation efforts, the National Cancer Institute recommended including tobacco-treatment education in the curricula of all US medical schools by 1995.[5] However, several more recent reports[6,7,8] suggest that the overall rate of inclusion of tobacco control training in medical as well as nursing school education continues to remain relatively low, the focus is somewhat superficial, and few schools actually teach specific smoking cessation interventions.


Over the past 50 years, tobacco use among medical students in the United States has steadily declined, and surveys have found that only 2 to 10% of the graduating medical students in the United States used tobacco compared to smoking rates of > 25% in the general population during the 1990s.[9,10] Relatively less data are available on smoking trends in nursing students in the United States, but reports[11,12] indicate that prevalence rates of smoking range from 15 to 25%. In 1999, a multidisciplinary model to offer smoking cessation services and develop smoking-related education and research activities was established at Thomas Jefferson University, Philadelphia. An important mission of this center was to improve curricula for smoking-related education for medical and nursing students in the university. We believed that prior to implementation of new curricula, basic information about tobacco smoking among medical and nursing student population would be important since their approach and credibility as treatment providers may be influenced by their own smoking habits. Additionally, the information on possible differences in smoking habits of medical and nursing students may help to individualize the educational program for medical and nursing students, as emphasized by the National Cancer Institute expert panel on promoting undergraduate education in smoking cessation.[5]


Although sufficient data about smoking habits of medical and nursing students exist, frequently the data collection instruments did not include assessments of severity of smoking. Also, relatively few studies have reported on smoking habits of these groups in the United States during recent years, a period marked with increasing public attention focused on smoking cessation. Moreover, data on systematic comparisons of medical and nursing students from the same university during the same time period are very limited. The purpose of the study was to investigate the smoking habits of medical and nursing students enrolled in a major university in the United States, and to examine whether smoking habits changed during the course of education for each group using a cross-sectional survey approach.

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