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Prevalence of tobacco use in healthcare workers: A systematic review and meta-analysis

Author

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  • Kapka Nilan
  • Tricia M McKeever
  • Ann McNeill
  • Martin Raw
  • Rachael L Murray

Abstract

Objectives: To estimate tobacco use prevalence in healthcare workers (HCW) by country income level, occupation and sex, and compare the estimates with the prevalence in the general population. Methods: We systematically searched five databases; Medline, EMBASE, CINHAL Plus, CAB Abstracts, and LILACS for original studies published between 2000 and March 2016 without language restriction. All primary studies that reported tobacco use in any category of HCW were included. Study extraction and quality assessment were conducted independently by three reviewers, using a standardised data extraction and quality appraisal form. We performed random effect meta-analyses to obtain prevalence estimates by World Bank (WB) country income level, sex, and occupation. Data on prevalence of tobacco use in the general population were obtained from the World Health Organisation (WHO) Global Health Observatory website. The review protocol registration number on PROSPERO is CRD42016041231. Results: 229 studies met our inclusion criteria, representing 457,415 HCW and 63 countries: 29 high-income countries (HIC), 21 upper-middle-income countries (UMIC), and 13 lower-middle-and-low-income countries (LMLIC). The overall pooled prevalence of tobacco use in HCW was 21%, 31% in males and 17% in females. Highest estimates were in male doctors in UMIC and LMLIC, 35% and 45%, and female nurses in HIC and UMIC, 21% and 25%. Heterogeneity was high (I2 > 90%). Country level comparison suggest that in HIC male HCW tend to have lower prevalence compared with males in the general population while in females the estimates were similar. Male and female HCW in UMIC and LMLIC tend to have similar or higher prevalence rates relative to their counterparts in the general population. Conclusions: HCW continue to use tobacco at high rates. Tackling HCW tobacco use requires urgent action as they are at the front line for tackling tobacco use in their patients.

Suggested Citation

  • Kapka Nilan & Tricia M McKeever & Ann McNeill & Martin Raw & Rachael L Murray, 2019. "Prevalence of tobacco use in healthcare workers: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-26, July.
    • Handle: RePEc:plo:pone00:0220168
    DOI: 10.1371/journal.pone.0220168
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    3. Masudus Salehin & Louisa Lam & Muhammad Aziz Rahman, 2025. "Smoking Among Healthcare Professionals in Australia: A Scoping Review," IJERPH, MDPI, vol. 22(1), pages 1-33, January.
    4. Antonio Ranchal-Sánchez & Esperanza Romero-Rodríguez & Jose Manuel Jurado-Castro & África Ruiz-Gandara & Manuel Vaquero-Abellán, 2020. "Impact of a Comprehensive Anti-Smoking Program at a Regional University Hospital and Predictive Variables of Being a Smoker among Hospital Workers," IJERPH, MDPI, vol. 17(22), pages 1-12, November.
    5. Natascha Mojtahedzadeh & Felix Alexander Neumann & Elisabeth Rohwer & Albert Nienhaus & Matthias Augustin & Volker Harth & Birgit-Christiane Zyriax & Stefanie Mache, 2021. "The Health Behaviour of German Outpatient Caregivers in Relation to the COVID-19 Pandemic: A Mixed-Methods Study," IJERPH, MDPI, vol. 18(15), pages 1-30, August.
    6. Elpidio Maria Garzillo & Maria Grazia Lourdes Monaco & Anna Rita Corvino & Alessia Giardiello & Antonio Arnese & Francesco Napolitano & Gabriella Di Giuseppe & Monica Lamberti, 2022. "Smoking Habits and Workplace Health Promotion among University Students in Southern Italy: A Cross-Sectional Pilot Investigation," IJERPH, MDPI, vol. 19(17), pages 1-12, August.

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