Are physicians aware of their role in tobacco control? A conference-based survey in Portugal

Ravara, Sofia B.; Castelo-Branco, Miguel; Aguiar, Pedro; Calheiros, José M.

http://hdl.handle.net/10400.18/2372

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Authors

Ravara, Sofia B.

Castelo-Branco, Miguel

Aguiar, Pedro

Calheiros, José M.

Abstract(s)

BACKGROUND: The crucial role of physicians in tobacco control (TC) is widely recognized. In 2008, Portugal implemented a non-comprehensive smoke-free policy (SFP). In 2009, a conference-survey was carried out to explore Portuguese physicians' engagement in tobacco control, by evaluating the following: 1) attendance at TC training and awareness of training needs; 2) participation in TC activities; 3) attitudes and beliefs regarding SFPs. METHODS: Questionnaire-based cross-sectional study conducted during two major national medical conferences targeting GPs, hospitalists, and students/recent graduates. Descriptive analysis and logistic regression were performed. RESULTS: Response rate was 63.7% (605/950). Of the 605 participants, 58.3% were GPs, 32.4% hospitalists, 9.3% others; 62.6% were female; mean age was 39.0 ± 12.9 years. Smoking prevalence was 29.2% (95% CI: 23.3-35.1) in males; 15.8% (95% CI: 12.1-19.5) in females, p < 0.001. While the overwhelming majority of physicians strongly agreed that second-hand smoke (SHS) endangers health, awareness of SFP benefits and TC law was limited, p < 0.001. A significant minority (35.5%) believed that SHS can be eliminated by ventilation systems. Most physicians lacked training; only a minority (9.0%) participated regularly in TC. Training was the most consistent predictor of participation in TC. General agreement with SFP was high; but significantly lower for indoor leisure settings, outdoors bans in healthcare/schools settings and smoking restrictions in the home/car, p < 0.001. Smoking behaviour strongly predicted support for smoking restrictions in restaurants and bars/discos, healthcare outdoors and private settings. CONCLUSIONS: The findings suggest that Portuguese physicians are not aware of their role in tobacco control. Poor engagement of physicians in TC may contribute to the current lack of comprehensive policies in Portugal and Europe and undermine social norm change. Medical and professional continuing education on tobacco control should be made top priorities.

Description

Authors’ contributions: SBR conceived the study and gathered the information, completed data entry, data analysis and drafting of the manuscript. All authors participated in the design of the study, analysed and interpreted the data and critically reviewed the original draft. SBR and JMC coordinated the study design. PA coordinated the statistical analysis. All authors read and approved the final manuscript.
Acknowledgements: The authors would like to thank the survey respondents for their participation and also the board and organising committee of the two conferences. In addition, the authors would like to thank Steve Dyson for the English text review.

Keywords

Tobacco Control Smoking Physicians Doctors Smoke-free Policies SHS ETS Training Tabaco Políticas de Saúde Estilos de Vida e Impacto na Saúde Saúde Pública Portugal