Abstract
The prevalence of smoking among trainee nurses and the role that occupational stress may have in acquiring or maintaining the habit continues to attract keen interest among investigators. This multidisciplinary study has attempted to elucidate several obscure and unresolved issues emanating from earlier investigations. The results from this study were acquired from two complementary investigations. One, a cross-sectional national questionnaire survey examined smoking and stress in the nursing profession and sampled 35,825 nurses of all grades. The other consisted of an 18 month longitudinal investigation into stress and smoking among trainee nurses. In the longitudinal study twenty female trainees, half just commencing and the remainder midway through their training were recruited as subjects from one district nurse training school. Psychometric and subjective questionnaires, ambulatory electrocardiographic recordings and biochemical specimens were systematically gathered from each subject while allocated to various specialities. This study has demonstrated that there is strong evidence to suggest that the incidence of smoking among nurses increased, or If already smoking the number of cigarettes consumed increased significantly during their training period. There was no evidence that trainee nurses had personality or psychological characteristics which were any different from the general female population, neither was there evidence that smoking nurses could be distinguished by personality or psychological traits from non-smoking colleagues. The results suggested that trainee nurses are generally happy, stimulated and satisfied with their nursing duties; indeed apart from geriatrics, no speciality was perceived as particularly stressful. Primary sources of stress, cited by trained and trainee nurses, tended to originate from factors supplemental to actual nursing duties; for example, examinations, heavy workloads and unharmonious working relationships - stressors which are certainly not unique to the nursing profession. Psychiatry had the highest proportion of smokers, with casualty and geriatrics second and third highest but with numbers much lower. The lowest proportion of smokers, at half the rate of psychiatry, was found among nurses employed in the community. As psychiatry, casualty and geriatrics were not considered stressful, the possibility that different areas of nursing impose different stresses which is reflected by the incidence of smoking was not demonstrated. Evidence indicated that it is not appropriate to employ biochemical or physiological techniques to measure stress in situations where the individual or it is not possible to adequately control the environment.