How male Jordanian Psychiatric Nurses became Regular Smokers at University: Lessons in Tolerance, Cultural Identity and Stress Reduction

This paper presents smoking experience of Jordanian psychiatric nurses (JSNs) when they were nursing students and how the contextual factors in Jordanian universities and faculties of nursing influenced their smoking behaviours to become regular smokers. Background: Smoking is endemic in Jordan especially among male nursing students despite their awareness of its harmful effects. Smoking is a risk factor for the students themselves, and for their future patients. A better understanding of how male Jordanian psychiatric nurses became regular smokers when they were students is needed if smoking reduction programs and smoking cessation programs are to be effective in reducing smoking in Jordanian psychiatric hospitals and faculties of nursing. Aim: To explore retrospectively how male JPNs became regular smokers when they were studying nursing. Method: A classical grounded theory study of eight male psychiatric nurses employed in Amman was conducted to better understand why smoking is endemic among them and how they contextualized smoking into their lives to be regular smokers. Findings: Becoming regular smokers is the basic psychological process that explains how male Jordanian psychiatric nurses integrate smoking into their lives. Jordanian universities and faculties of nursing play a paradoxical role in socializing male nursing students into regular smoking behaviours while at the same time instructing them about the importance of health promotion and patient education. As a result, male nursing students learn to become regular smokers, but not how to assist themselves or their patients to cope with stress in less harmful ways. Five contextual factors influence male Jordanian nursing students to transition from occasional to regular smoking: the stressful demands of university nursing programs; encouragement to smoke from other students; lax enforcement of university non-smoking policies; no access to smoking reduction programs or smoking cessation programs; and gaps in nursing curricula. Conclusion: There are contextual and cultural factors in Jordanian universities and faculties of nursing that result in male nursing students becoming regular smokers. The findings reported here make the case for smoking prevention programs and smoking cessation program in Jordanian universities. They are particularly relevant to university administrations, nursing faculty, and health promotion specialists.