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Spanish primary health care nurses who are smokers: this influence on the therapeutic relationship


Susana González, Department of Nursing and Physiotherapy, University of Balearic Islands, Cra. de Valldemossa, km 7.5, 07122 Palma, Spain; Tel: 34-971173306; Fax: 34-971173190; E-mail:


Aim:  To identify the perception of Primary Health Care (PHC) female nurses in the Balearic Islands in Spain who are smokers, regarding the suitability of their anti-smoking therapeutic relationships with their clients. Also, to identify what factors they consider may determine why nurses smoke less in PHC than in specialized care (SC).

Background:  Backed by the signing of the WHO Framework Convention on Tobacco Control (WHO FCTC), a new Anti-Smoking law has been in force in Spain since 2006. This legislation limits the places where tobacco may be consumed. PHC nurses, because of their professional abilities, their number and their direct contact with society on all accounts – both health- and illness-wise – and also because of the proven efficacy of their interventions in the fight against the smoking habit, are called upon to play an important role against the smoking habit in the 21st century.

Method:  A qualitative study using a semi-structured interview with 15 PHC female nurses who are smokers.

Findings:  Regarding the therapeutic relationship, basically two attitudes are adopted: first, blaming themselves and feeling uncomfortable and inadequate to be able to help someone to give up smoking or, second, considering themselves to be in an optimum situation in which to be able to help by sharing their addiction and thereby understanding and empathizing much more with clients. PHC nurses believe they smoke less than SC nurses as a result of a greater degree of awareness.

Conclusion:  We would suggest that SC nurses should acquire a more relevant role in the fight against the smoking habit. In light of their capacity, commitment and efficacy, we believe there is a case for total autonomy as far as their role as therapists in breaking smoking habits is concerned.