International Journal of Environment, Ecology,

Family and Urban Studies (IJEEFUS)

ISSN(P): 2250-0065; ISSN(E): 2321-0109
Vol. 4, Issue 6, Dec 2014, 37-44
TJPRC Pvt. Ltd.

A STUDY ON SMOKING HABIT AMONG HEALTH STAFF IN BASRA CITY, IRAQ

SAJJAD SALIM ISSA
University of Basrah, College of Nursing, Iraq

ABSTRACT
A study on smoking habit among health staff carried out at three general hospitals in Basra city. 168 health staff
was included in the sample, 28 of them was smokers and 140 was none smoker. The questionnaire was c divided into two
parts, part for the smokers and the other part for none smokers
The result shows that Basra general hospital has the highest rate of smokers. Most of the smokers consume about
20 cigarettes per day and the period of smoking is different. Fortunately it seem that about 86% of smokers consider
smoking as a bad habit. 75% of them try quit smoking, most of them (96 % ) know the hazardous effect of smoking on the
respiratory system of their children and their pregnant women. The result of nonsmokers included 98 % agreed that
smoking is a bad habit, 97 % of them did advice the smokers to quit smoking. 73 % of them are affected by smoking from
smokers. 91 % agree with preventing smoking in closed areas. 82 % think that busy parent can be a cause of smoking by
teenagers. 89 % agree that smoking is a major cause of behavioral problems in the society.
Our study showed that about 15 % of the health staff are smokers, 90 % of our sample agree to stop smoking in
general places. 86% of smokers consider smoking as a bad habit and 82 % agree to stop smoking if somebody help them
and (96 %) knows the hazardous effect of smoking on the respiratory system of their children and their pregnant women.

KEYWORDS: Smoking, TIPS, Drug Abuse

INTRODUCTION
INTRODUCTION AND REVIEW OF LITERATURES
General Smoking Facts
Cigarette smoking has been identified as the most important source of preventable morbidity and premature
mortality worldwide. Smoking-related diseases claim an estimated 443,000 American lives each year, including those
affected indirectly, such as babies born prematurely due to prenatal maternal smoking and victims of "secondhand"
exposure to tobaccos carcinogens. Smoking cost the United States over $193 billion in 2004, including $97 billion in lost
productivity and $96 billion in direct health care expenditures, or an average of $4,260 per adult smoker.(1)
Health Hazards of Smoking
Cigarette smoke contains over 4,800 chemicals, 69 of which are known to cause cancer. Smoking is directly
responsible for approximately 90 percent of lung cancer deaths and approximately 80-90 percent of COPD deaths. (2)
About 8.6 million people in the U.S. have at least one serious illness caused by smoking. That means that for
every person who dies of a smoking-related disease, there are 20 more people who suffer from at least one serious illness
associated with smoking.(3)

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Sajjad Salim Issa

Among current smokers, chronic lung disease accounts for 73 percent of smoking-related conditions. Even among
smokers who have quit chronic lung disease accounts for 50 percent of smoking-related conditions (4)
The list of diseases caused by smoking includes chronic obstructive pulmonary disease, coronary heart disease,
stroke, abdominal aortic aneurysm, acute myeloid leukemia, cataract, pneumonia, periodontitis, and bladder, esophageal,
laryngeal, lung, oral, throat, cervical, kidney, stomach, and pancreatic cancers. (5)
Smokers die significantly earlier than nonsmokers: 13.2 years for men and 14.5 years for women. (6)
Smoking During Pregnancy
Smoking in pregnancy accounts for an estimated 20 to 30 percent of low-birth weight babies, up to 14 percent of
preterm deliveries, and some 10 percent of all infant deaths. (7)
Neonatal health-care costs attributable to maternal smoking in the U.S. have been estimated at $366 million per
year, or $704 per maternal smoker. (8)
Smoking Prevalence
In 2009, an estimated 46.6 million, or 20.6% of adults (aged 18+) were current smokers. The annual prevalence of
smoking declined more than 50 percent between 1965 and 2009. Males tend to have significantly higher rates of smoking
prevalence than females. In 2009, 23.5 percent of males currently smoked compared to 17.9 percent of females. (9)
Secondhand Smoke
Secondhand smoke involuntarily inhaled by nonsmokers from other peoples cigarettes is classified by the U. S.
Environmental Protection Agency as a known human (Group A) carcinogen, responsible for approximately 3,400 lung
cancer deaths and 46,000 (ranging 22,700-69,600) heart disease deaths in adult nonsmokers annually in the United States.
(10) Smoking by parents is associated with a wide range of adverse effects in their children, including exacerbation of
asthma, increased frequency of colds and ear infections, and sudden infant death syndrome. Secondhand smoke causes
more than an estimated 202,000 asthma episodes. (11)
Quitting Smoking
In 2009, an estimated 49.9 million adults were former smokers. Of the 46.6 million current adult smokers, 46.7
percent stopped smoking at least 1 day in the preceding year because they were trying to quit smoking completely. (12)
Quitting smoking often requires multiple attempts. Using counseling or medication alone increases the chance of
a quit attempt being successful; the combination of both is even more effective. (13)

REVIEW OF LITERATURES
A Study of smoking habits in hospital and attitudes of medical staff towards smoking done by Harvard School of
Public Health, Huntington, Boston, showed that most hospital policies place little or no restriction on patients' smoking in
hospital. In this study patients were surveyed to determine if they smoked and if their doctors advised or ordered them to
stop smoking in hospital. As well, the smoking habits and attitudes towards smoking of the medical staff and other hospital
workers were explored. Of 741 patients 37% were smokers, and those who responded fully to a questionnaire 86%
continued to smoke in hospital. Patients who were advised or ordered not to smoke (59%) were no more likely to stop

Impact Factor (JCC): 3.0965

Index Copernicus Value (ICV): 3.0

39

A Study on Smoking Habit among Health Staff in Basra City, Iraq

smoking than those who were not so advised or ordered. (14).

A study showed that most hospital policies place little or no restriction on patients' smoking in hospital. In this
study patients were surveyed to determine if they smoked and if their doctors advised or ordered them to stop smoking in
hospital. As well, the smoking habits and attitudes towards smoking of the medical staff and other hospital workers were
explored. Of 741 patients 37% were smokers, and those who responded fully to a questionnaire 86% continued to smoke in
hospital. Patients who were advised or ordered not to smoke (59%) were no more likely to stop smoking than those who
were not so advised or ordered. Physicians were less likely to smoke than other hospital staff, and those who did smoke
were much more likely not to smoke while in the hospital. Physicians appear to have a reasonable appreciation of the
health hazards of smoking, and almost two thirds are in favor of stricter restrictions on patients' smoking in hospital.
The ineffectiveness of their efforts is primarily due to hospital policies that are not in keeping with physicians' standards of
practice and with established knowledge of the deleterious effects of smoking on health (15)

METHODOLOGY
Design of the Study
A cross sectional study designed to assess health staff knowledge about smoking habit
Setting of the Study
The study was carried out in three general hospitals in Basra center

Basra general hospital

Almoani general hospital

Teaching hospital

The Sample of the Study

168 health staff was included in the sample through interviewing them for the purpose of the study.
The questionnaire consist of two parts, one for the smoker's staff and the other for nonsmokers. The questionnaire for the
smokers is again had 2 section. The first as a direct question to the smokers, second section which is similar to that part of
the nonsmokers.

RESULTS
168 health staff was included in the sample through interviewing them for the purpose of the study, 28 of them
was smoker and the rest was none.
Table 1: Describing Distribution of the Sample According to Hospital
No
1
2
3

Hospital Name
Basra general hospital
Almoani hospital
Teaching hospital

The Smokers
12
8
8

The Nonsmokers
55
40
45

From the table 1 it is clear that the smokers represent 16 % from the studied sample, that is to say 16 % of the
health staff are smokers. Basra general hospital has the highest rate of smokers,

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Sajjad Salim Issa

Table 2: Demographic Data Table for Smokers

Sex

Graduation Level

Male

Female

27

Secondary
13

Marital Status

Diploma
11

Bachelors
4

Married
26

Unmarried
2

From the table 2 it seems that most smokers are male and most of them are married, 46% of them have secondary
graduation, while 39% are diploma and, and14% are bachelors.
Table 3: Demographic Data Table for Nonsmokers
Sex

Graduation level

Male

Female

68

82

Secondary
45

Diploma
89

Marital Status

Bachelors
16

Married
102

Unmarried
48

The table shows that 48% of them are male and 58% are female, regarding graduation 32% have secondary level,
63% have diploma and 11% only have bachelor. 72% are married and 34 % are unmarried.
Table 4: The Enquiry Part One as Direct Question to Smokers
Question
Cause of smoking

Average smoking

Period of smoking

Answer
Bad friend
Family problem
Social problem
Others
Less than 10 cigarette
20 cigarette
40 cigarette
Less than 10 years
10- 20 years
21-30 years
31-40 years

No.
12
7
6
3
8
16
4
7
9
7
5

From the table it is clear that bad friend is the common cause of smoking, most of the smokers consume about 20
cigarettes per day and the period of smoking are different
Table 5: The Enquiry Part Two as Indirect Question to Smokers
No
1
2
3
4
5
6
7
8
9

Question
Did you consider smoking as a bad habit
Did you try to stop smoking
Did you avoid reading risk of smoking in
the newspapers
Did you affect any of your surroundings by
smoking
Did your father or other relatives are
smokers
Did feel the risk of smoking
Did you know that passive smoking is risky
to your children and made them more
affected by respiratory diseases
Is it difficult for you to stop smoking at
general locations like airport
Are agree that one of your family to be a
smoker at his future life

Impact Factor (JCC): 3.0965

Agree Strongly
18
6

Agree
6
15

Disagree
4
7

14

14

11

11

11

13

15

12

13

6
23

Index Copernicus Value (ICV): 3.0

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A Study on Smoking Habit among Health Staff in Basra City, Iraq

10
11
12
13
14
15

Table 5: Contd.,
If we help you to stop smoking are agree to
stop such habit
Did you know the passive smoking
Did you know that passive smoking is badly
affect your pregnant women
Most of the smoker are young
Smoking habit is greatly expanding in the
society
Smoking is a waste of money

15

11

14

13

20

20

18

Fortunately it seems that about 85% of smokers consider smoking as a bad habit. 75% of them try quit smoking.
50% are affecting the surroundings by their smoking, 78 % of them carry positive family history of smoking. 85 % of them
did feel the risk of smoking. 82 % agree to stop smoking if somebody help them. 71 % are know what passive smoking
meant. Most of them (9 %) know the hazardous effect of smoking on the respiratory system of their children and their
pregnant women.
82% are disagreeing for any person in their family to be smokers at futures. 89 % agree that smoking is mostly in
young. 96 % said that smoking habit is clearly expanding in the society. About 92 % said that smoking is wasting of
money
Table 6: The Enquiry Part Two Indirect Question to Nonsmokers
No
1
2
3
4
5
6
7
8
9
10
11
12

Question
Did you consider smoking as a bad habit
Did your father or other relatives are smokers
Did your health is affected by smoking from others
Did you try smoking
Did you try to prevent nearby smoker from smoking
Did you try to help smokers to stop smoking or to be assistant
in stop smoking center
Did you think that violence is a way to stop smoking
Did you advice smokers to stop smoking
Did smoke affect any of your surroundings or relatives
Did you agree with the thought of preventing smoking in the
public areas
Did you think that a busy parent is a cause that made
teenagers go toward smoking s
Did you think that smoking is a key for other behavioral
problems like alcohol drinking and drug addiction

Strongly Agree
120
31
47
10
71

Agree
16
60
52
17
54

Disagree
3
58
49
124
16

66

66

18

6
81
42

15
56
65

129
3
34

85

51

14

54

68

29

76

58

17

97 % agreed that smoking is a bad habit, 65% carry positive family history, fortunately only 19 % have trial of
smoking in the past, 89 % are preventing smokers to use cigarette near to them. 94% are trying to help smokers to quit
smoking. 15% only agree that violence can be a way to quit smoking. 97 % of them did advice the smokers to quit
smoking. 70 % of them are affected by smoking from smokers. 97 % agree with preventing smoking in closed areas. 87 %
think that busy parent can be a cause of smoking by teenagers. 95% agree that smoking is a major cause of behavioral
problems in the society.

DISCUSSIONS, CONCLUSIONS AND RECOMMENDATIONS

Discussions
our study showed that about 16 % of the health staff are smokers, while a similar study in Hila appears that 23 %

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Sajjad Salim Issa

of health staff are smokers Study of smoking habits in hospital and attitudes of medical staff towards smoking done by
Harvard School of Public Health, Huntington, Boston, showed that 37 % of the health staff was smokers, 90 % of our
sample agree to stop smoking in general places while only 67 % of Harvard study, in our study 71 % consume one and
more pack per day while in Hila study there is about 67 % whom consuming one pack per day.
Smokers
Most smokers are considering smoking as a bad habit so it is possible if we do our best to make them quit
smoking. What encourage us to do such is that most of them were tried to quit smoking. In addition 87 % of nonsmokers
are ready to the smokers to quit smoking.
It is clear that bad friend is the common cause of smoking, this indicate that the choose of the good friend is
consider a form of protection from being a smoker for any teenage. most of the smokers consume about 20 cigarettes per
day and the period of smoking are different this mean the smokers will spend large amount of money for smoking which
might be beneficial from him to spend them on more important things. It seems that about 85% of smokers consider
smoking as a bad habit. 75% of them try quit smoking. This indicates it is possible for smokers to stop smoking if we insist
on them for stopping. (96 %) of the smokers know the hazardous effect of smoking on the respiratory system of their
children and their pregnant women this might obligates them to stop smoking while them at home.

CONCLUSIONS

The number of smokers is more in the Basra general hospital

Bad friend is the common cause of smoking

85% of smokers consider smoking as a bad habit

82 % agrees to stop smoking if somebody helps them

(96 %) know the hazardous effect of smoking on the respiratory system of their children and their pregnant
women.

RECOMMENDATIONS

Assist the work of social workers and other health promotion workers in their work in the smoker's advices to quit
smoking

Make meeting and workshop for the smokers about smoking hazards

Make a committee in each hospital try to do their best in persuading smokers to quit smoking

REFERENCES
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Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and
Productivity Losses United States, 20002004 Weekly Report. November 14, 2008; 57(45):122628.

2.

Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health
Promotion. Tobacco Information and Prevention Source (TIPS). Tobacco Use in the United States. January 27,
2004.

Impact Factor (JCC): 3.0965

Index Copernicus Value (ICV): 3.0

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A Study on Smoking Habit among Health Staff in Basra City, Iraq

3.

Centers for Disease Control and Prevention. Cigarette Smoking Attributable Morbidity U. S, 2000. Morbidity
and Mortality Weekly Report. 2003 Sept; 52(35): 842-844.

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Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice
Guideline. Rockville, MD: U. S. Department of Health and Human Services. Public Health Service. May 2008

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U.S Department of Health and Human Services. Health Consequences of Smoking: A Report of the Surgeon
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Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Potential Life Lost,
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U. S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General, 2001.

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Centers for Disease Control and Prevention. State Estimates of Neonatal Health-Care Costs Associated with
Maternal Smoking United States, 1996. Morbidity and Mortality Weekly Report. October 8, 2004; 53(39):
915-917.

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Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview
Survey, 2009.Analysis by the American Lung Association, Research and Program Services Division using SPSS
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10. Washington DC National Youth Tobacco Survey: American Legacy Foundation. October 2000.
11. California Environmental Protection Agency. Proposed Identification of Environmental Tobacco Smoke as a
Toxic Air Contaminant: Executive Summary. June 24, 2005.
12. Shopland DR, Gerlach KK, Burns DM, Hartman AM, Gibson JT. State-Specific Trends in Smoke-free Workplace
Policy Coverage: The Current Population Tobacco Use Supplement, 1993 to 1999. Journal of Occupational and
Environmental Medicine. August, 2001; 43(8):680-6.
13. National Institute of Drug Abuse. Research Report on Nicotine: Addiction, August 2001
14. Department of Population and International Health, Harvard School of Public Health, 665 Huntington Avenue,
Boston, MA 02115, USA
15. Campbell D. Smoking policies in hospitals. Dimens Health Serv. 1976 Dec, 53(12):2023. [Pub Med]

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