Academic journal article The Qualitative Report

Becoming a Novice Smoker: Initial Smoking Behaviours among Jordanian Psychiatric Nurses

Academic journal article The Qualitative Report

Becoming a Novice Smoker: Initial Smoking Behaviours among Jordanian Psychiatric Nurses

Article excerpt

It is now more than 15 years since attention was drawn to increasing rates of smoking in countries of the Eastern Mediterranean Region including Jordan (World Health Organization [WHO], 1997). The passage of time has not decreased the negative impact of smoking on health of the Jordanian population. Consequently, smoking remains a major health hazard in the country despite warnings (Department of Statistics in Jordan, 2002) of its consequences. Haddad and Malak in 2002 have noted smoking remains an intractable cause of morbidity and mortality in Jordan. According to Ma'ayeh (2003) "... cardiovascular diseases are responsible for about 42% of deaths in Jordan; and cancer is responsible for a further 13% of all deaths" (p. 1). As a result, there has been increasing concern in Jordan about the risks associated with smoking, particularly about the deteriorating health status of regular smokers. However, the effects of regular smoking on the health of male psychiatric nurses in Jordan has not been investigated previously, anyone familiar with psychiatric hospitals in Jordan is aware of the high prevalence of regular smoking among male psychiatric nurses as well as among patients; although there are no national statistics available about actual prevalence rates.

Smoking Behaviours in Adolescence

Behaviors formed in adolescence are a significant precursor of health problems experienced in later life. Accordingly, it is important to understand how behaviors that impact negatively on the health of adults are influenced by life style choices at a much younger age. Therefore, if we are going to understand the regular smoking behaviours of the eight nurses in our sample, we need to be aware of risk factors that affected them as many as 20 years ago. Although each generation has its distinctive characteristics, we can begin to understand continuities in the risk factors that influence rates of smoking in Jordan. However, when we investigate the origin of smoking behaviours in Jordanian male psychiatric nurses today, there are meager sources of information because there no systematic studies were published before 2006. The best we can do is to draw attention to such recent evidence of smoking prevalence rates in the country, while stressing that much has changed since six of the eight nurses in our sample were adolescents. Although allowance has to be made for rising standards of living in Jordan and the influence of social media that has come to affect when, where and how, young men congregate and influence the health behaviors of one another, we believe that the process of starting smoking is for many male Jordanian adolescents of today essentially similar to that led to the regular smoking habits of the nurses in our sample. The data we present from our study adds context and detail to the results reported in the quantitative studies we have cited.

When we refer to the nurses in our sample as regular smokers, we are aware that classifications of smoking behaviours such as that used by Wilson, Parsons, and Wakefield (1999), who defined a heavy smoker as a person who smokes 25 cigarettes or more a day, are not particularly helpful. We describe the nurses in our sample as regular smokers on the basis that they smoke on average 28.5 cigarettes a day. It should be noted as well, they are subject to almost continuous passive smoking due to the smoke they inhale from their colleagues, no less than from their patients.

Best Available Evidence

We drew on the following informative studies to help us apply the constant comparative method (Glaser & Strauss, 1967), an important methodological component of grounded theory studies, because they represent the best available evidence on the smoking habits of adolescents and young adults in Jordan. We stress that we prefer that it would have been possible to present smoking prevalence rates in the age group 18-25 years aggregated in periods of five years commencing with 1981-1985 because would have enabled us to relate our findings about the nurses in our sample to known smoking prevalence rates. …

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