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David E. Nelson, MD, MPH; Gary A. Giovino, PhD; Seth L. Emont, PhD; Robert Brackbill, PhD; Lorraine L. Cameron, PhD; John Peddicord, MS; Paul D. Mowery, MS

JAMA. 1994;271(16):1273-1275.

Abstract
Objective.
—To determine trends in cigarette smoking prevalence among physicians, registered nurses, and licensed practical nurses since 1974.

Design.
—Analyses of data on smoking prevalence among persons 20 years of age and older using combined National Health Interview Survey data sets from 1974,1976, and 1977; 1978,1979, and 1980; 1983 and 1985; 1987 and 1988; and 1990 and 1991.

Main Outcome Measures.
—Prevalence of cigarette smoking and average annual change in smoking prevalence.

Results.
—Based on the data for 1990 and 1991, there were an estimated 18 000 physicians, 322 000 registered nurses, and 128 000 licensed practical nurses who smoked cigarettes in the United States. Compared with 1974, 1976, and 1977, by 1990 and 1991 cigarette smoking prevalence had declined from 18.8% to 3.3% among physicians (average annual decline of 1.15 percentage points); from 31.7% to 18.3% among registered nurses (average annual decline of 0.88 percentage point); and from 37.1% to 27.2% among licensed practical nurses (average annual decline of 0.62 percentage point).

Conclusion.
—Since 1974, cigarette smoking has declined most rapidly among physicians, at an intermediate rate among registered nurses, and at a lower rate among licensed practical nurses. Because of their important roles as exemplars and health educators, persons in these occupations should not smoke.

(JAMA. 1994;271:1273-1275)

Author Affiliations
From the Office on Smoking and Health, (Drs Nelson, Giovino, Emont, and Mr Peddicord), the Office of Surveillance and Analysis, (Dr Brackbill), National Center for Chronic Disease Prevention and Health Promotion, and the National Institute for Occupational Safety and Health (Dr Cameron), Centers for Disease Control and Prevention, Atlanta, Ga; and Batelle, Inc, Arlington, Va (Mr Mowery).

Footnotes
Reprint requests to the Office on Smoking and Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-50, Atlanta, GA 30342-3724 (Dr Giovino).

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