Smoking prevalence had been steadily decreasing in the United States until 1993 when the rate stabilized. In 1993 there were 46 million adult smokers, which represented 25% of adults aged 18 years and older. Between 1983 and 1993, smoking prevalence among white men declined from 34% to 27% and from 41% to 32% in black men. Smoking prevalence among women declined from 30% to 27%. Currently, smoking prevalence is still higher for men than women, 28% and 23% respectively. More than 70% of adults began their daily habit of smoking by the age of 18 years. The frequency of this habit is highest among Native Americans/Native Alaskans (39%) compared with that of other ethnic groups. It is interesting that smoking prevalence is highest among men who are high-school dropouts (42%). Our role as healthcare providers is clear. We must protect our patients and society from the consequences of smoking. But healthcare professionals must first lead by example. Although the frequency of smokers is decreasing in this segment of society, it was still 18% for RNs and 27% for licensed practical nurses in 1991. Among physicians, the frequency of smokers has decreased from 19% in 1976 to 3% in 1991. With respect to effects on human health and the costs of tobacco use, our direction, responsibility, and duty to our patients and society are very clear.

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