Contextualizing Smoking Behaviour over Time: Smoking Journey from Pleasuring to Suffering

Smoking prevalence among psychiatric health nurses poses a serious health concern in the Western world. However, the salient factors that affect smoking among these nurses in many parts of the world, including Jordan, are still unclear. This grounded theory study was designed to address this dearth of knowledge. The primary objective of this study was to generate a substantive theory that incorporates and explains the contextual factors that may contribute to smoking behaviour among Jordanian psychiatric health nurses [JPHN], and the meanings that they attributed to smoking. Such a framework was expected to develop health promotion and smoking cessation programs that are culturally relevant. The guiding theoretical framework was symbolic interactionism.

A classical grounded theory approach was used to collect and analyze the (interview and observational, and sociogram) data derived from a theoretical (purposeful) sample. The constant comparative method of data analysis developed by Glaser and Strauss (1967) was used; thus, data collection, coding and analysis occurred simultaneously. The sample for this study was eight JPHN participants who smoked. A number of strategies were employed throughout the study to ensure trustworthiness; that is, the data collection and interpretation accurately reflects the phenomenon. These strategies included credibility, transferability, dependability and confirmability.

The generated substantive theory consists of one core category or basic psychosocial process "Contextualizing smoking behaviour over time" and four supporting categories and their corresponding sub-categories. The categories were: Becoming a novice smoker, Becoming a formal smoker nursing student, Becoming a heavy smoker psychiatric health nurse, and Becoming an exhausted smoker. All categories converged to provide support for the core category, "Contextualizing smoking behaviour over time".

Contextualizing smoking behaviour over time explains how JPHN who smoked integrated smoking behaviour into their entire life fabric and how a range of contextual factors influenced this process in and through time and space. A brief discussion has been provided regarding the implications of the findings of this study for nursing science, nursing education, advanced nursing practice, and administration. Limitations of the study and recommendations for future research have also been discussed.