PURPOSE: Following the establishment of the Philanthropic Hospital in Tokyo in 1886 and the Regulation on the Training of Relief Nurses in 1889, the Japanese Red Cross Society (JRCS) started to train relief nurses in 1890 in order to develop highly qualified nurses. The JRCS used its own nursing textbooks as well as several other textbooks for nursing education.
METHODS: We investigated 10 nursing textbooks published between 1890 and 1910 to find descriptions of smoking/nonsmoking issues. After examining every page of the above-mentioned textbooks, the contents of each description were summarized.
RESULTS: Half of the 10 textbooks contained descriptions of smoking/nonsmoking. The textbook for army nursing students published in 1890 described that smoking pollutes the air and that patients must not smoke in the sickroom and corridors. Another textbook, published by the JRCS in 1896 suggested that since smoking is very harmful to many patients and contaminates the air, nurses should not allow people to smoke in sickrooms. The use of cigarette ash was recommended for tooth-brushing if there were no better options available. Two other textbooks, published in 1896 and 1908, respectively, also referred to the prohibition of smoking in sickrooms. The JRCS’s textbook published in 1910 mentioned that only certain patients were permitted to smoke in the designated area. It is also stated that nurses should not smoke at work, and that a patient’s smoking on the day of an operation was prohibited.
CONCLUSIONS: Although there was no description about smoking in the famous Nightingale’s “Notes on Nursing” published in 1859, she pointed out the hazards of smoking and chewing tobacco for boys and girls in revisions for a proposed 1875 edition. In 1900, the Japanese government enacted the first legislation in the world to prohibit smoking under 20 years of age (Act on Prohibition of Smoking by Minors). It is interesting that old Japanese nursing textbooks over 100 years ago had descriptions of smoking/nonsmoking and indicated the restriction of patients’ smoking in the hospital.
CLINICAL IMPLICATIONS: Antismoking education.
DISCLOSURE: The following authors have nothing to disclose: Hiroshi Kawane, Sayuri Watanabe, Naoko Takeshita
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