Background:
Research shows that in many developing countries, not only health professionals are insufficiently involved in tobacco control and smoking cessation interventions, but there is a high prevalence of smoking among them.

Objectives:
The aim of this study is to identify smoking status among employees in healthcare institutions in Serbia, especially among medical doctors and nurses.

Methods:
Data on smoking prevalence of employees in public healthcare institutions are collected within the national survey on employees’ satisfaction, which is implemented annually. A question on smoking status has been added in the standard questionnaire in 2018 wave. Data were collected from 324 health institutions. In total, 71512 questionnaires were distributed and completed by 59997 employees present on the day of the survey, while 53592 employees provided an answer to smoking status.

Results:
More than one-third (35.2%) of employees in public healthcare institutions smoke daily (25.8%) or occasionally (9.45%), and 18.3% are former smokers. Percentage of smokers is lower among medical doctors (24.2%) compared to nurses/medical technicians (37.3%) and administrative (36.7%) and technical staff (44.4%). Less medical doctors smoke (daily or occasionally) at primary healthcare level (23.1%) compared to secondary (25.4%) and tertiary level (25.5%). Differences in smoking status among nurses/medical technicians according to the level of healthcare are even more significant with 33.6% smoking at primary level, 39.0% at secondary, and 41.2% at the tertiary level of healthcare.

Conclusion:
Smoking prevalence among health professionals in Serbia is high, especially among nurses/medical technicians and medical staff in secondary and tertiary healthcare institutions. High smoking prevalence is a significant barrier to implementation of smoking cessation, including brief interventions. These findings call for the implementation of a tailored intervention in Serbia that is aimed at health professionals at all levels of healthcare.