key: cord-0825889-jcbvhe2p authors: Firat, Meryem; Demir Gökmen, Burcu; Karakurt, Papatya title: An investigation of smoking habits and mental well‐being in healthcare personnel during COVID‐19 date: 2021-04-30 journal: Perspect Psychiatr Care DOI: 10.1111/ppc.12819 sha: 3034af74f2172c105ad79fbe177a68ab4173e3c1 doc_id: 825889 cord_uid: jcbvhe2p AIM: This study aimed to the smoking levels of the healthcare personnel (n = 761) in Turkey, the changes in their smoking levels, and their mental well‐being levels. DESIGN AND METHODS: Data were collected via social networks from various cities in Turkey using a personal information form, the Fagerstrom test for nicotine dependence, the Warwick–Edinburgh mental well‐being scale. FINDINGS: Their mean nicotine dependence score was 3.50 ± 2.57 and mental well‐being score was 25.01 ± 5.44. The frequency of smoking during the pandemic was increased in 22.4% of the participants and was the same as that before the pandemic in 57.4% of the smokers. PRACTICE IMPLICATIONS: It is an introductory study of the current situation for healthcare professionals and researchers. It suggests protecting mental well‐being and reducing smoking. The coronavirus disease 2019 (COVID- 19) pandemic is a crisis defined as a global threat. During such a crisis, people tend to make irrational decisions and exhibit inappropriate behaviors because of negative emotions. In particular, healthcare personnel, who have to continue to perform their duties, experience stress and difficulties because of the fear of contracting the infection, the possibility of spreading it to their family members, the guilt in the case they pass it on to their loved ones, and the fact that their lives are at risk. Although people feel similar emotions under difficult conditions, each person shows different emotional and behavioral reactions. 1 Smoking is a reaction shown to cope with difficult situations. 2 Individuals smoke to eliminate their negative feelings, such as fear, anxiety, and anger and feel positive. They describe smoking as a relaxing, pleasant, and satisfying habit. 3 Many factors play a role in starting, continuing, and quitting smoking. One of these factors is psychological resilience, which is a part of positive psychology. 4, 5 Individuals who do not smoke are reported to be more resilient than those who smoke. [5] [6] [7] Although the terms psychological resilience, psychological hardiness, psychological well-being, subjective wellbeing, and mental well-being have different meanings, they are used interchangeably across various studies in the literature. 8 Mental well-being of individuals depends on their ability to cope with stress, awareness of their skills, feeling positive emotions more often and negative emotions less frequently, self-acceptance, autonomy, and ability to use environmental resources. 9 In today's dynamic world, individuals are affected by both external and internal stimuli. Smoking is an external stimulus, while mental well-being is an internal stimulus. Thus, the question that needs to be asked is "Does smoking affect mental well-being, or does mental well-being affect smoking"? Healthcare personnel are significant role models for the society; therefore, the status of their smoking habit is equally critical. 10 Regardless of the country or society, all healthcare personnel across the world have played an active role and undertaken more burden during the COVID-19 pandemic. It is considered that in adapting to this process, their smoking and mental well-being levels may change due to their emotional burden and heavy workload. Thus, this study aimed to determine the answers to the following questions: This descriptive study aimed to determine the smoking levels of the healthcare personnel in Turkey, the changes in their smoking levels, and their mental well-being levels. The study population consisted all of the 1,061,635 healthcare personnel affiliated to the Ministry of Health in Turkey. 11 The study sample included all healthcare personnel who could be contacted using the snowball sampling method. The sample size calculation formula for the populations where the number of individuals is known was used to determine the minimum sample size. The results of this calculation showed that a minimum of 384 healthcare personnel should be included; however, the researchers aimed at contacting the maximum possible number of healthcare personnel. The snowball sampling method was used in the study. In this method, one of the units of the population is contacted. With the help of the contacted unit, researchers contact the second unit, and with the help of the second unit, they contact the third unit. Thus, the sample size grows in a manner similar to the growth of a snowball. 12 The data collection tools prepared based on this information for the purpose of this study were transferred to the online environment. The link to these forms were shared by the researchers with the healthcare personnel known to them via various applications (WhatsApp, Instagram, etc.), and these healthcare personnel were asked to share the forms with other healthcare personnel they knew. Data accumulation was followed daily, and the data collection was completed since no data accumulated for a week. This study aimed to analyze the smoking habits and mental well-being levels of the healthcare personnel during the COVID-19 pandemic; the results obtained were discussed in line with the results reported in the literature, and accordingly, some recommendations were made. Between 2000 and 2014, the incidence of smoking among healthcare personnel was 18%-21% in the countries with a high revenue, 22%-28% in the countries with a moderate revenue, and 15%-23% in the countries with a low revenue. 15 Turkey is classified as a country with a moderate revenue. 16 This study was conducted with 761 healthcare personnel working in various cities in Turkey, and 31.1% of the participants were found to be smoking. The rate of smoking among healthcare personnel reported in Turkey was higher than that reported in other countries around the world. Comparison of the rate of smoking reported in the present study with that reported in previous studies conducted in Turkey showed a decrease in the rate of smoking over the past years. The results reported in some recent studies are consistent with those reported in this study, 17, 18 whereas studies conducted in the past report a higher incidence of smoking. 19, 20 The results of the present study showed that the smoking rate decreased during the COVID-19 pandemic in Turkey, which complies with the World Health Organization recommendations most and the world leader in fighting against tobacco. The legal measures implemented to curb the use of tobacco may have affected the results. In this study, the mean mental well-being score of the healthcare personnel were 25.01 ± 5.44. Considering the minimum and maximum scores that can be obtained in the scale, it may be stated that this value was above average, and the healthcare personnel who participated in the study were mentally well. Previous studies have examined the mental and psychological well-being of healthcare personnel, and the mean mental well-being scores obtained in the present study are similar to those reported in previous studies. [21] [22] [23] However, it is important to note that the previous studies were conducted in the pre-COVID-19 era, and FIRAT ET AL. It was a limitation of this study that the majority of the participants of the study consisted of nurses. Additionally, because the pandemic increased the workload of healthcare personnel, participation in the study was limited. Therefore, these results may be generalized to not all healthcare personnel in Turkey but only those who were included in the scope of the study. The results of this study showed minor changes in the frequency of smoking and high levels of mental well-being among healthcare personnel. These findings suggest that this pandemic, which is a painful process that is still ongoing and is expected to last for an unpredicted period, did not affect the frequency of smoking level and mental well-being of the healthcare personnel. Since only a limited number of studies have addressed this topic, it is recommended that further studies be conducted with larger sample sizes. Further, qualitative studies should be conducted with a focus on the positive features of positive psychology. These studies may also contribute to the studies to be conducted on fighting against smoking. In addition, adequate support should be provided to healthcare personnel, who play an important role during such situations, for maintaining their mental well-being. The authors want to thank the healthcare personnel who participated in this study. 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Data will be made available on request. Data available in article supplementary material. Shared data availability only upon request.