engleski

Tobacco control policy and the burden of smoking among doctors and nurses in Koprivnica-Krizevci County, Croatia

Background: A comprehensive national smoke-free law in Croatia was put into effect in December 1999 and since then smoking has been prohibited in all health care facilities. The WHO Framework Convention on Tobacco Control was put into effect in October 2008 and since then smoking has been prohibited in the yard around health care facilities. Increasing our understanding of smoking patterns among the different professional groups in health care facilities will help inform the development of interventions for persons bearing the burden of tobacco use. Methods: A cross-sectional study of smoking habits via a self-administered questionnaire among doctors and nurses who were employed in health care facilities was performed across four points in time: 1998 (a year and a half before implementation of the Act), and 2002, 2006 and 2011 (2, 6 and 11 years after the implementation). By census, there were between 734 and 1, 014 doctors and nurses and response rate were 50-69%. Results: The surveys showed that the lowest smoking prevalence was among doctors and the highest was among nurses. During the study period, the smoking prevalence in all professional groups had a downward trend, although different professional groups showed different intensity of decline. The decrease was greatest among doctors (from 28.3% in 1998 to 19.4% in 2011) and nurses with junior college education (from 32.6% in 1998 to 25.2% in 2011). The smallest change was among nurses with a high school education (from 36.4% in 1998 to 30.4% in 2011). The greatest decrease in smoking prevalence was recorded among doctors and nurses with junior college education in the first two years since the Act came into effect and among nurses with a high school education after 2 to 6 years since the law came into effect. Conclusion: Much progress has been made in reducing tobacco use in Croatia in the last decade by introducing comprehensive smoke-free legislation. A smoke-free workplace has a positive and long lasting impact on the smoking prevalence among health care professionals although higher education level and better knowledge about risk of smoking on health might have a role in that. However, increasing taxes and prices of the tobacco product, strengthening controls and comprehensive cessation programs are needed.

tobacco; smoking; doctors; nurses; Croatia

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