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

Nilan, Kapka; McKeever, Tricia M.; McNeill, Ann; Raw, Martin; Murray, Rachael L.

Abstract

© 2019 Nilan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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.

Citation

Nilan, K., McKeever, T. M., McNeill, A., Raw, M., & Murray, R. L. (2019). Prevalence of tobacco use in healthcare workers: A systematic review and meta-analysis. PLoS ONE, 14(7), Article e0220168. https://doi.org/10.1371/journal.pone.0220168

• Journal Article Type: Article
• Acceptance Date: Jul 16, 2019
• Online Publication Date: Jul 25, 2019
• Publication Date: Jul 25, 2019
• Deposit Date: Jul 23, 2019
• Publicly Available Date: Jul 31, 2019
• Journal: PLOS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 7
• Article Number: e0220168
• DOI: https://doi.org/10.1371/journal.pone.0220168
• Keywords: General Biochemistry, Genetics and Molecular Biology; General Agricultural and Biological Sciences; General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/2334032
• Publisher URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220168
• Contract Date: Jul 31, 2019