05-1Epidemiology of smoking in HCW

Smoking epidemiology in smoke-Smoking epidemiology in smoke-free hospitalsfree hospitals

Numerous data exists showing that in most European countries, health-care workers smoke less than the general population, but in many situations they are heavy smokers.

05-2Epidemiology of smoking in HCW

Tobacco Consumption in EuropeTobacco Consumption in Europe15 years and older15 years and older

21% 27%

19%

37%

27%

19%27%

28%

28%

26%

26%

29%15%

26%

24%

42%31%

37%

45%27%

40%

46%

29%38%32%

36%

38%

28%

22%

37%

MalesFemales

Sweden

U.Kingdom

Portugal

Netherlands

Luxembourg

Italy

Ireland

Greece

France

Finland

Spain

Denmark

Belgium

Austria

Germany

From: U.E. OMS March 1996

05-3Epidemiology of smoking in HCW

Smoking: Attributable mortalitySmoking: Attributable mortality

1/5 of all deaths in all ages.

1/4 of all deaths in people aged between 35 – 64 years

Smokers aged between 35–69 years who die from a tobacco related illness, lose around 22 years of their life expectancy.

05-4Epidemiology of smoking in HCW

Tobacco attributable mortality in EU Tobacco attributable mortality in EU (1955 – 1995)(1955 – 1995)

From : Peto, Lopez 1992, 1994

1955 1965 1975 1985 1990 1995

1028

479776 89

324

423 442 423392

184

/1 000

Males

Females

05-5Epidemiology of smoking in HCW

Male

Female

05

101520253035404550

1950 1960 1970 1980 1990 2000

Acc

um

ula

ted

mil

lio

ns

of

dea

ths

Tobacco attributable mortality in Tobacco attributable mortality in developed countries (1950 – 2000)developed countries (1950 – 2000)

From : Peto et all Oxford University Press 1992, A22

05-6Epidemiology of smoking in HCW

Smoking habit of Bispebierg Smoking habit of Bispebierg Hospital in Denmark.Hospital in Denmark.

Olsen AD et al. Active and passive smoking among hospital staff at the

Bispebjerg hospital 1992-1999. Ugeskrift for Laeger. 162(42):5623-7,2000 Oct 16.

SmokingFemales

Smoking Males

33% 32%

Complaint for passive smoking= 25%

05-7Epidemiology of smoking in HCW

Smoking habits of HCW in Italian Smoking habits of HCW in Italian hospitalshospitals

Nardini S. et al. Personal smoking habit and attitude toward smoking among the health staff of a general hospital. Monaldi Archives for Chest Disease. 53(1):74-8,1998

44%39%

HCW smokers Physician smokers

05-8Epidemiology of smoking in HCW

Smoking habits of Spanish nurses Smoking habits of Spanish nurses

Fernandez Ruiz ML, Sanchez Bayle M. Prevalence of smoking by women physicians and nurses in the community of Madrid. Revista Espanola de Salud Publica. 73(3):355-64,1999

47%53%

Smoking nurses No smoking nurses

05-9Epidemiology of smoking in HCW

Smoking habit of hospital Smoking habit of hospital HCW in FranceHCW in France

Grizeau D et al. Attitudes et comportement du personnel hospitalier face au tabagisme. Revue des maladies respiratoire 1998,15,79-87.

Smokers females

Smokers males

31,2% 36,8%

Smoking habits among

HCW in France 32,6%

05-10Epidemiology of smoking in HCW

Smoking habits of midwifes and student nurses (IFSI) in Smoking habits of midwifes and student nurses (IFSI) in AP-HP in France.AP-HP in France.

0%

20%

40%

60%

80%

100%

Midwife IFSI Feb 2000 IFSI Oct 2000

Regular smoker

Occasional smoker

Ex- smoker

Non- smoker

05-11Epidemiology of smoking in HCW

Survey of smoking habits of HCW in Survey of smoking habits of HCW in European hospitalsEuropean hospitals

• The ENSH proposes to include 13 standard questions in a survey of all health care workers, to be able to compare differences in European countries.

• 2 page questionnaire is also available.

05-12Epidemiology of smoking in HCW

13 questions on smoking habits of HCW13 questions on smoking habits of HCWage <20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 >60ansSex male femaleYour job: Technical Administrative Physician Nurse others Are you at the management level: yes no

Did you work : at fix hours at various hours never the night, sometime the night always the night

Have you smoke some cigarettes in your life ? yes no Presently are you : no-smoker ? former smoker ? smoker ? (since> 1 month) (at least 1/day)

SMOKERS On average, how many cigarettes do you smoke a day ? <1 1 2-3 4-5 6-9 10-13 14-19 20-24 25-29 30-34 35-40 41-60 >60 How long after waking up do you smoke your first cigarette? < 5 minutes 6-30 minutes 31-60 minutes > 60 minutesDo you plan to stop to smoke :  In the next 3 months in the 6 months within the year not at this time no

Smoke in your environment

smoker ex-smoker non-smokerYour company is: Your nearest colleague is: Your nearest friend is:

05-13Epidemiology of smoking in HCW

22 questions on your opinion on tobacco in hospital22 questions on your opinion on tobacco in hospitalSmoking room exist in the hospital ? yes no Nobody smoke in the hospital (except in smoking room) yes no Conflict exist between smokers and non-smokers yes no Protection of non-smoker had to be reinforce ? yes no Smoking room had to be better (more) managed ? yes no I am regularly disturbed by the tobacco smoke of the others  ? yes no Hospital will be better take in account smoker problems ? yes noIs you colleagues encourage you to be a non-smoker ? yes noWhich activity encourages you to smoke

Meeting yes no Discussion yes no Coffee break yes no

Treatment yes no During the night yes no Meals yes no

Are you disturbed by the tobacco smoke of others very often often sometime never

Have you ever complained about tobacco smoke:  In your work place very often often sometime neverIn your hospital very often often sometime neverIn other public places very often often sometime never

Do you think that trying to convince others to quit tobacco is part of your job ?  ? yes, certainly yes, in some case no

As a HCW, do you think you have an exemplary role for patients yes no In your activity sector is there :

A staff smoking room yes no A non-smokers staff room yes no