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A national qualitative study of tobacco use among career firefighters and department health personnel.

ABSTRACT: INTRODUCTION:Firefighters currently have substantially lower smoking rates than similar occupational groups and the general U.S. population. In contrast, firefighters have very high rates of smokeless tobacco (SLT). The reasons for this paradox have not been explored; thus, the current study examined firefighters' perspectives on tobacco use. METHODS:Key informant interviews and focus groups were conducted in a national, cross-sectional purposively sampled group of 332 career firefighters. RESULTS:Firefighters suggested several reasons for the decline in smoking in the fire service including changes in the fire service culture, concerns about the impact of smoking on their ability to perform their job, regulations aimed at reducing smoking in departments, and the costs of smoking. In contrast, they felt that the greater use of SLT was primarily due to increasing restrictions on smoking. CONCLUSIONS:The primary reasons cited for decreased smoking rates by firefighters in our study were policy implementation at the state and local levels that prohibit tobacco use as a condition of employment and related presumption laws. However, reasons beyond policy mandates such as witnessing the end results of tobacco use, fitness, greater education about the negative health effects of smoking, and awareness about increased risk of exposure to toxic products of combustions also were noted. The primary reason cited for increased SLT use was the greater restrictions on smoking.

SUBMITTER: Poston WS

PROVIDER: S-EPMC6281053 | biostudies-other | 2012 Jun

REPOSITORIES: biostudies-other

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A national qualitative study of tobacco use among career firefighters and department health personnel.

Poston Walker S C WS Haddock C K CK Jitnarin Nattinee N Janhke Sara A SA

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 20111216 6

<h4>Introduction</h4>Firefighters currently have substantially lower smoking rates than similar occupational groups and the general U.S. population. In contrast, firefighters have very high rates of smokeless tobacco (SLT). The reasons for this paradox have not been explored; thus, the current study examined firefighters' perspectives on tobacco use.<h4>Methods</h4>Key informant interviews and focus groups were conducted in a national, cross-sectional purposively sampled group of 332 career fire ...[more]

PMID: 22180587

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Project description:BackgroundThe rates of emergency department (ED) utilization vary substantially by type of health insurance, but the association between health insurance type and patient-reported reasons for seeking ED care is unknown.ObjectiveWe evaluated the association between health insurance type and self-perceived acuity or access issues among individuals discharged from the ED.Design, patientsThis was a cross-sectional analysis of the 2011 National Health Interview Survey. Adults whose last ED visit did not result in hospitalization (n = 4,606) were asked structured questions about reasons for seeking ED care. We classified responses as 1) perceived need for immediate evaluation (acuity issues), or 2) barriers to accessing outpatient services (access issues).Main measuresWe analyzed survey-weighted data using multivariable logistic regression models to test the association between health insurance type and reasons for ED visits, while adjusting for sociodemographic characteristics.Key resultsOverall, 65.0% (95% CI 63.0-66.9) of adults reported ? 1 acuity issue and 78.9% (95% CI 77.3-80.5) reported ? 1 access issue. Among those who reported no acuity issue leading to the most recent ED visit, 84.2% reported ? 1 access issue. Relative to those with private insurance, adults with Medicaid (OR 1.05; 95% CI 0.79-1.40) and those with Medicare (OR 0.98; 95% CI 0.66-1.47) were similarly likely to seek ED care due to an acuity issue. Adults with Medicaid (OR 1.50; 95% CI 1.06-2.13) and Medicaid + Medicare (dual eligible) (OR 1.94; 95% CI 1.18-3.19) were more likely than those with private insurance to seek ED care for access issues.ConclusionVariability in reasons for seeking ED care among discharged patients by health insurance type may be driven more by lack of access to alternate care, rather than by differences in patient-perceived acuity. Policymakers should focus on increasing access to alternate sites of care, particularly for Medicaid beneficiaries, as well as strategies to increase care coordination that involve ED patients and providers.

Project description:BackgroundSuperwoman refers to the identity of a woman who performs several important roles simultaneously and full-time, such as being a wife, mother, and homemaker while holding a job. This study aims to examine the career experiences of Iranian superwomen who maintained their mental health while holding multiple roles.MethodsData for this qualitative study were collected via semi-structured interview and analyzed using conventional content analysis. The study participants were 12 multi-role women from different occupations in Tabriz, North West of Iran selected through purposive and theoretical sampling. The women's mental health status was assessed using Mental Health Continuum-Short Form questionnaire before participating in the research.ResultsThe results were classified into three main categories. The first category included Underlying Factors of Job Experience with six subcategories, including Limited job opportunities for women, Educational context (mindset shaped in the parental home), Commitment or freedom in obtaining a job and its continuation, Personality traits, and Non-cognitive skills (emotional intelligence and spiritual intelligence); the second category included the adopted strategies to solve career problems with two subcategories: effective strategies, including the benefits of having a mindset of abundance and having a vision and strategic planning, and ineffective strategies, including the benefits of having a mindset of scarcity; and the third category included Perceived Consequences of employment with two subcategories: psychological consequences and social consequences, with both subcategories including some positive and negative further subcategories. Moreover, a conceptual relationship between the main categories and the subcategories was evident.ConclusionsThe content obtained not only supports the findings about the experiences of multi-role women in cultures outside Iran, but also points to the unique aspects of Iranian superwomen's life experiences and narratives. The findings of this study can help us perceive the real career experiences from the perspective of Iranian professional women with multiple roles.

Dataset Information

A national qualitative study of tobacco use among career firefighters and department health personnel.

Publications

A national qualitative study of tobacco use among career firefighters and department health personnel.

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