Changes in self-reported smoking among university hospital employees over two decades: a repeated cross-sectional study

Abstract Background Smoking among hospital employees remains an important public and occupational health concern. Healthcare professionals are particularly relevant because of their role in smoking prevention and cessation. This study compared self-reported smoking prevalence among employees of a large university hospital approximately 20 years apart, with additional analyses by sex, age, and profession. Methods This repeated cross-sectional study compared two independent samples of employees undergoing mandatory occupational health examinations in 2002–2005 and 2024–2026. The study population included physicians, nurses, and other hospital employees. Smoking status was self-reported using the same general yes/no question (“Do you smoke?”) in both periods. Prevalence was compared according to sex and age group, with predefined subgroup analyses of physicians and nurses. Pearson’s chi-squared test or Fisher’s exact test was used for categorical comparisons, as appropriate. Results The samples comprised 3,209 employees in 2002–2005 and 1,342 in 2024–2026. Overall self-reported smoking prevalence decreased from 27.4% to 15.9% ( p < 0.001), from 27.1% to 16.1% among women and from 28.7% to 15.2% among men (both p < 0.001). Prevalence also decreased among female nurses (29.9% to 20.5%; p < 0.001), female physicians (12.1% to 2.0%; p = 0.003), and male physicians (17.9% to 7.6%; p = 0.006). Conclusions Self-reported smoking declined substantially among employees of the same university hospital over approximately two decades and was particularly low among physicians in the contemporary sample. Smoking remained more prevalent among nurses than physicians. Because the questionnaire did not distinguish between conventional cigarettes and newer tobacco or nicotine products, the findings reflect trends in self-reported smoking rather than overall tobacco or nicotine use.