05-1 Epidemiology of smoking in HCW Smoking epidemiology in smoke- free 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.

05-2 Epidemiology of smoking in HCW Tobacco Consumption in Europe 15 years and older 21% 27% 19% 37% 27% 19% 27% 28% 26% 29% 15% 26% 24% 42% 31% 37% 45% 27% 40% 46% 29% 38% 32% 36% 38% 28% 22% 37% Males Females Sweden U.Kingdom Portugal Netherlands Luxembourg Italy Ireland Greece France Finland Spain Denmark Belgium Austria Germany From: U.E. OMS March 1996

05-3 Epidemiology of smoking in HCW Smoking: 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.

05-4 Epidemiology of smoking in HCW Tobacco attributable mortality in EU (1955 – 1995) From : Peto, Lopez 1992, /1 000 Males Females

05-5 Epidemiology of smoking in HCW Male Female Accumulated millions of deaths Tobacco attributable mortality in developed countries (1950 – 2000) From : Peto et all Oxford University Press 1992, A22

05-6 Epidemiology of smoking in HCW Smoking habit of Bispebierg Hospital in Denmark. Olsen AD et al. Active and passive smoking among hospital staff at the Bispebjerg hospital Ugeskrift for Laeger. 162(42):5623-7,2000 Oct 16. Smoking Females Smoking Males 33% 32% Complaint for passive smoking = 25%

05-7 Epidemiology of smoking in HCW Smoking habits of HCW in Italian hospitals 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, % 39% HCW smokersPhysician smokers

05-8 Epidemiology of smoking in HCW 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, % 53% Smoking nursesNo smoking nurses

05-9 Epidemiology of smoking in HCW Smoking habit of hospital HCW in France Grizeau D et al. Attitudes et comportement du personnel hospitalier face au tabagisme. Revue des maladies respiratoire 1998,15, Smokers females Smokers males 31,2% 36,8% Smoking habits among HCW in France 32,6%

05-10 Epidemiology of smoking in HCW Smoking habits of midwifes and student nurses (IFSI) in AP-HP in France. 0% 20% 40% 60% 80% 100% MidwifeIFSI Feb 2000IFSI Oct 2000 Regular smoker Occasional smoker Ex- smoker Non- smoker

05-11 Epidemiology of smoking in HCW Survey of smoking habits of HCW in European 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.

05-12 Epidemiology of smoking in HCW 13 questions on smoking habits of HCW age  60ans Sex  male  female Your 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         >60 How long after waking up do you smoke your first cigarette?  60 minutes Do 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-smoker Your company is:    Your nearest colleague is:    Your nearest friend is:   

05-13 Epidemiology of smoking in HCW 22 questions on your opinion on tobacco in hospital Smoking 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  no Is you colleagues encourage you to be a non-smoker ?   yes  no Which 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  never In your hospital  very often  often  sometime  never In 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