Smoking-related behaviour and attitudes among medical students in Alexandria

As a preliminary step toward incorporating a tobacco education and intervention program into our undergraduate medical curriculum, this study was designed to assess students' smoking-related behaviour, knowledge and attitudes towards tobacco, and perceptions of their future role as doctors in smoking intervention. A cross-sectional, study was conducted in the university year 2001/2002 on a representative sample of male medical students enrolled in 4th and 5th years at Alexandria University. A total of 320 students across the 2 years completed the survey. The smoking rate among medical students was 17.5% (10.9% smoked daily and 6.6% occasionally). The awareness of harmful effects of smoking and knowledge about the causal role of tobacco in the development of specific diseases were deficient. The intention to perform smoking intervention in the future as doctors seemed unsatisfactory. About 85% of the students thought that doctors should carry out smoking cessation advice depending on the disease, while the rate of those who thought so irrespective of the disease did not reach 44%. Current smokers thought less actively about smoking intervention than non-smokers. Nearly two-thirds of students (65.3%) felt they were not sufficiently prepared for caring or counseling smokers, and only 31.9% of students were convinced of the effectiveness of the doctor's advice to stop smoking. Seventy-seven and half percent of them desired specific training in smoking intervention. Non-smokers were more in favour of legislative actions to discourage tobacco use than current smokers. These findings suggest that medical school authorities should design and implement an appropriate basic training aimed at better preparing medical students for their future role in prevention of smoking. Specific teaching of medical students about smoking-related diseases and a patient-centered smoking cessation intervention is required to provide future medical practitioners with the knowledge and skills they need to effectively intervene with smokers.     

Tobacco use prevalence, knowledge and attitudes, and tobacco cessation training among medical students: results of a pilot study of Global Health Professions Students Survey (GHPSS) in Italy

Aim

The aims of this study were to examine tobacco use prevalence, knowledge and attitudes, and tobacco cessation training among students attending Italian medical schools using the Global Health Professions Student Survey approach and to identify possible factors associated with smoking status.

Subjects and Methods

A multicentre cross-sectional pilot study was carried out in five Italian Schools of Medicine from March to April 2009. Questionnaires were administered in anonymous, voluntary and self-administered form to third year students attending medical schools. The outcome measure was ??being a current smoker??. A logistic regression was used to evaluate possible factors associated with smoking status.

Results

The prevalence of current smokers was 31.4%. More than half considered health professionals as models for patients, and around 90% thought health professionals have a role in giving advice or information about smoking cessation. Only 5.8% of responders had received smoking cessation training during medical school. Medical students who considered healthcare professionals as behavioural models had lower likelihood of smoking (OR?=?0.52).

Conclusions

Given the high prevalence of smokers among medical students and the poorness of smoking cessation programmes, it is important to create tobacco control training programmes addressed to healthcare students.     

Effectiveness of smoking cessation interventions: review of evidence and implications for best practice in Australian health care settings

OBJECTIVE: To review the evidence of the effectiveness of various smoking cessation methods and appropriateness for use in Australian health care settings. METHODS: Cochrane and other existing reviews and meta-analyses of evidence were the basis for the review. Systematic literature searches were also conducted to identify relevant controlled trials published internationally between January 1999 and May 2002. The main inclusion criteria for studies were use of a controlled evaluation design and an outcome measure of continuous abstinence from smoking for at least five months. A three-tiered grading system for strength of evidence was used. RESULTS: Clinic and hospital systems to assess and document tobacco use and routine provision of cessation advice can double long-term quit rates. While brief intervention can achieve a significant effect at population level, at individual level there is a strong dose response between the number and length of sessions of tobacco cessation counselling and its effectiveness. Effective behavioural interventions can increase cessation rates by 50-100% compared with no intervention. Some pharmacotherapies are safe and also help to substantially increase cessation rates. CONCLUSIONS: Effective behavioural and pharmacological methods of tobacco cessation are available. IMPLICATIONS: Every smoker should be offered evidence-based advice and treatment to quit smoking. This includes pharmacotherapy, unless contra-indicated. Health professionals and health care settings can play a significant role in motivating and assisting smokers to quit.     

The development of an adolescent smoking cessation intervention--an Intervention Mapping approach to planning

The objective of this project was to develop a theory- and evidence-based adolescent smoking cessation intervention using both new and existing materials. We used the Intervention Mapping framework for planning health promotion programmes. Based on a needs assessment, we identified important and changeable determinants of cessation behaviour, specified change objectives for the intervention programme, selected theoretical change methods for accomplishing intervention objectives and finally operationalized change methods into practical intervention strategies. We found that guided practice, modelling, self-monitoring, coping planning, consciousness raising, dramatic relief and decisional balance were suitable methods for adolescent smoking cessation. We selected behavioural journalism, guided practice and Motivational Interviewing as strategies in our intervention. Intervention Mapping helped us to develop as systematic adolescent smoking cessation intervention with a clear link between behavioural goals, theoretical methods, practical strategies and materials and with a strong focus on implementation and recruitment. This paper does not present evaluation data.     

中国初中学生烟草使用及其影响因素研究

目的 了解中国初中学生烟草使用的情况,探讨烟草使用行为的主要影响因素。方法 采用多阶段分层整群随机抽样的方法,在31个省（自治区、直辖市）初中在校学生中选取调查样本。采用学生自填问卷的方式收集数据,调查烟草使用、二手烟暴露、烟草制品获得与价格、控烟宣传、烟草广告和促销、对烟草的认知和态度等内容。对数据加权后,采用SAS 9.3软件复杂调查数据分析程序进行数据分析。结果 共调查155 117名初中学生,烟草使用率为6.9%,男生（11.2%）高于女生（2.2%）,农村（7.8%）高于城市（4.8%）,西部地区（10.3%）高于中部地区（6.4%）且两者均高于东部地区（4.5%）,差异均有统计学意义。看到控烟媒体宣传、在课堂上学习过烟草导致具体健康危害知识是烟草使用的保护因素;父母吸烟（尤其是母亲吸烟）、教师吸烟、好朋友吸烟、每周零花钱>20元、看到烟草广告或促销、二手烟暴露、对烟草成瘾的错误认知以及对吸烟行为的正向态度是烟草使用的危险因素。结论 中国初中男生吸烟率高于全球平均水平,值得关注。采取宣传教育、提高烟草价格、全面禁止烟草广告和促销、公共场所禁止吸烟等一系列综合干预措施,对降低青少年吸烟率有意义。     

Short-term impact of a university based smoke free campaign

STUDY OBJECTIVE: The aim of this study was to evaluate the impact of a smoke free programme implemented at the University of Geneva, Switzerland, in 1996. This programme included a prohibition to smoke in university buildings everywhere except in limited areas, and a smoking cessation counselling service. METHODS: Surveys were conducted before and four months after the programme was implemented, in representative samples of programme participants (n = 833) and university members not exposed to the programme (n = 1023). RESULTS: In retrospective assessments, participants reported being less bothered by environmental tobacco smoke after programme implementation, but no between group difference was detected in prospective assessments. Relationships between smokers and non-smokers improved moderately in the intervention group and remained unchanged in the comparison group (between group p = 0.001). Proportions of smokers who attempted to quit smoking in the past four months increased from 2.0% to 3.8% in the intervention group and remained unchanged at 3.5% in the comparison group (between group difference: p = 0.048). No impact on smoking prevalence (25%) was detected. The programme was appreciated by university members, although some of its modalities were criticised. CONCLUSION: A regulation prohibiting smoking everywhere but in limited areas of university buildings was acceptable and reduced the perception of bother by environmental tobacco smoke. It did not, however, influence smoking habits or attitudes toward smoking.     

Promoting smoking cessation among prisoners: feasibility of a multi-component intervention

OBJECTIVE:To conduct a pilot study to determine the feasibility and effectiveness of a multi-component smoking cessation intervention among prison inmates. METHODS: A prospective study conducted within a maximum-security prison located near Sydney, New South Wales, and housing around 330 men. Participants received a smoking cessation intervention with six-month follow-up to determine abstinence. The smoking cessation intervention consisted of two brief cognitive behavioural therapy sessions, nicotine replacement therapy, bupropion and self-help resources. Point prevalence and continuous abstinence at follow-up were verified with expired carbon monoxide measures. RESULTS: Thirty male inmates participated in the intervention. At six months, the biochemically validated point prevalence and continuous abstinence rates were 26% and 22% respectively. Reasons for relapse to smoking included: transfers to other prisons without notice, boredom, prolonged periods locked in cells, and stress associated with family or legal concerns. Those inmates who relapsed, or continued to smoke following the intervention, smoked less tobacco than at baseline and 95% stated they were willing to try to quit again using our intervention. CONCLUSIONS: Prison inmates are able to quit or reduce tobacco consumption while in prison but any smoking cessation intervention in this setting needs to address prison-specific issues such as boredom, stress, transfers to other prisons, court appearances, and isolation from family and friends. IMPLICATIONS: The prevalence of smoking within Australian prisons is alarmingly high. Further work into how to encourage prisoners to quit smoking is required.     

戒烟干预对吸烟者知识、态度和行为的影响

目的 评价戒烟干预对戒烟门诊求助者烟草相关知识、态度和行为(知、信、行)的影响。方法 以2008年10 月至2013 年8月解放军总医院戒烟门诊就医的未使用戒烟药物的吸烟者为研究对象,戒烟门诊医师首诊时为吸烟者进行≥30 min的面对面咨询和心理干预,之后1周、1个月、3个月和6个月时共进行4次随访电话干预(每次15～20 min).对照组为2012 年8月至2013 年8月解放军总医院健康医学中心某病区常规查体的吸烟者,基线和随访时均不进行干预。比较基线和1年随访时干预组和对照组烟草相关知、信、行的变化情况。结果 干预组和对照组分别纳入414例和213例研究对象。意向性分析显示,干预组1年随访烟草相关知、信方面共有5个变量的知晓/同意率高于基线。两组的1年随访时点戒烟率分别为4.7%和27.3%.logistic 多元回归分析显示,1年随访时戒烟率与暴露于戒烟干预、女性、尼古丁依赖评分低和烟草相关知识及态度正向变化(吸烟导致心脏病、应该禁止各种形式的烟草产品推广、吸烟浪费金钱和酒楼、饭店应该全面禁烟)共7个变量呈正相关,其OR值(95%CI)分别为2.85(2.00～4.07)、3.34(1.23～9.07)、2.78(1.64～4.72)、2.30(1.03～5.15)、5.33(1.47～19.32)、6.32(1.56～25.62)和10.47(2.25～48.84).结论 戒烟门诊求助者的烟草危害认知水平普遍较高,通过系统化戒烟干预,部分吸烟者知识及态度有了一定提高。烟草相关知识及态度的有益转变,有利于提高戒烟率。     

北京市社区吸烟者尝试戒烟行为及其影响因素研究

目的调查分析北京市成年吸烟者的尝试戒烟行为及影响因素。方法2018年12月至2019年8月,基于流行病学横断面研究,采用面对面问答式问卷调查。调查对象为18岁以上的社区吸烟者,调查内容包括基本人口学信息、烟草使用情况、尝试戒烟行为、烟草相关知识的认知、戒烟支持环境评估等;采用描述性分析统计调查对象的戒烟尝试行为,并采取χ2检验对其戒烟尝试行为与其社会人口学指标、烟草使用情况、烟草相关问题认知、戒烟支持环境等因素进行关联分析;采用二分类Logistic回归进一步探讨各因素与尝试戒烟行为的关系。结果共纳入449名调查对象,其中男性410人(91.3%),尝试戒烟与未尝试戒烟的分别为272人(60.6%)和177人(39.4%);月收入水平、烟草相关知识评估得分、周围人对戒烟的支持程度、过去1年是否就医、就医次数、过去1年是否有医务人员规劝戒烟、是否被医务人员询问过吸烟情况等因素为尝试戒烟行为的相关因素(P<0.05);Logistic回归分析显示,使尝试戒烟行为可能性提高的因素有月收入水平(OR=1.271,95%CI:1.081~1.493)、周围人对戒烟的支持(OR=1.251,95%CI:1.035~1.512)、过去1年有医务人员建议戒烟(OR=2.382,95%CI:1.054~5.381)。结论健康状况、环境支持、危害认知、经济水平、医生劝导等因素皆影响着尝试戒烟行为,自我毅力不足和他人影响是导致戒烟失败的主要原因。将社区场所作为干预基本单位,结合专业指导,形成医院-社区-线上综合联动的戒烟干预模式,是烟草依赖管理模式优化的新思路。     

Perceptions and practices of Japanese nurses regarding tobacco intervention for cancer patients

Background

We investigated the perceptions and practices regarding tobacco intervention among nurses, as improvement of such practices is important for the management of patients who smoke.

Methods

Self-administered questionnaires were delivered by hospital administrative sections for nursing staff to 2676 nurses who were working in 3 cancer hospitals and 3 general hospitals. Of these, 2215 (82.8%) responded.

Results

Most nurses strongly agreed that cancer patients who had preoperative or early-clinical-stage cancer but continued to smoke should be offered a tobacco use intervention. In contrast, they felt less need to provide tobacco use intervention to patients with incurable cancer who smoked. Most nurses felt that although they assessed and documented the tobacco status of cancer patients, they were not successful in providing cessation advice, assessing patient readiness to quit, and providing individualized information on the harmful effects of tobacco use. In multivariate analysis, nurses who received instruction on smoking cessation programs during nursing school were more likely to give cessation advice (odds ratio, 1.61; 95% confidence interval, 1.15–2.26), assess readiness to quit (1.73, 1.09–2.75), and offer individualized explanations of the harmful effects of tobacco (1.94, 1.39–2.69), as compared with nurses who had not received such instruction.

Conclusions

The perceptions of Japanese nurses regarding tobacco intervention for cancer patients differed greatly by patient treatment status and prognosis. The findings highlight the importance of offering appropriate instruction on smoking cessation to students in nursing schools in Japan.Key words: smoking cessation, intervention, nurses, perception     

Undergraduate dietetics programs do not support training students in smoking cessation

Although tobacco use is the leading contributor to death and disability in the United States, allied health professionals often lack knowledge of smoking cessation techniques. The objective of this study was to identify the extent to which undergraduate dietetics programs (referred to as didactic programs in dietetics [DPD]) teach about tobacco and smoking cessation interventions and also DPD directors' opinions regarding tobacco and smoking cessation in dietetics education. All DPD directors in the United States (n=231) were sent a questionnaire to assess programs' and directors' demographics, courses that included tobacco and smoking cessation education, and directors' opinions pertaining to tobacco and smoking cessation education. The response rate was 49% (n=113). On average, DPD directors did not agree that tobacco and smoking cessation education should be a formal part of undergraduate dietetics programs and that it is not as important as other content areas required of dietetics students. Just 37% of directors believed that a dietitian's job responsibility included educating patients on smoking cessation. Only 7% of DPD directors had formal education on smoking cessation and tobacco use, but 53% had formal education on behavior modification. More than half of DPD programs (56%) did not offer any courses that provided tobacco and smoking cessation education. These results indicate that most undergraduate dietetics programs do not incorporate tobacco and smoking cessation education in their curricula. Dietetics and other allied health educators could consider including smoking cessation education in their curricula to ensure that future health professionals can contribute to Healthy People 2010 objectives related to smoking cessation.     

Smoking behaviour and attitudes among Australian medical students

Teaching about tobacco and related diseases is essential in the undergraduate medical course in order for students to gain knowledge about smoking and how to intervene with patients who smoke. The objective of the study was to assess students'smoking-related behaviour, knowledge and attitudes towards tobacco, and perceptions of their future role as doctors. Data were collected from two consecutive years of year 1 and year 5 medical students at the University of New South Wales, Sydney. A total of 594 (79%) of students across the 2 years completed the survey: 90% of year 1 students, and 69% of year 5 students. The daily smoking rate among the total medical students was 2.9%: 11.8% in year 1 (2.3% daily, 9.5% occasional) and 13.7% in year 5 (3.3% daily, 10.4% occasional). There were significantly more male than female smokers in year 5 (P < 0.05). The overall smoking rates for males in years 1 and 5 were 12.4% and 19.3%, and the smoking rates for females were 11.2% and 8%. Knowledge about the causal role of tobacco in the development of specific diseases improved significantly from year 1 to year 5 (P < 0.001). Nevertheless, in year 5 there remained a lack of knowledge about the relationship of smoking and some diseases. Fifty-seven per cent of students thought that their current knowledge was sufficient to counsel smokers, with year 5 students (89%) being far more positive than year 1 students (34%) (P < 0.001). Teaching medical students about smoking-related diseases and a patient-centred smoking cessation intervention results in an increase in knowledge, as well as positive perceptions about their future role in intervening with smokers.     

某理科大学新生吸烟相关知识、态度、信念的基线调查研究

目的了解新入学大学生的吸烟相关知识、态度和信念,为学校制定有效的控烟政策提供依据。方法采用普查的方法对某大学新生吸烟知识、态度、信念进行调查。结果新入学男生尝试吸烟率为14.0%,女生为1.5%,总尝试吸烟率为10.7%;男生现在吸烟率为2.1%。只有48.26%的学生认为吸烟是肺癌的病因,其他癌症和疾病的因果关系认识更低。戒烟相关产品知晓率低于50%。92.69%的学生认为不吸烟对健康很重要,70.5%的学生认为需要开设烟草危害和控烟相关课程。结论该校新入学大学生尝试吸烟率、吸烟率低,具有积极的控烟态度和信念,相对缺乏烟草及吸烟危害健康的知识。学校应当及早对新生开设相关课程使学生认识到吸烟对健康的危害,完善相关制度,加快实现“无烟学校”的步伐。     

A school nurse-delivered adolescent smoking cessation intervention: a randomized controlled trial

BACKGROUND: The aim of the present study was to evaluate the efficacy of a school nurse-delivered smoking cessation intervention to improve abstinence rates among adolescents interested in quitting. METHODS: Seventy-one high schools in Massachusetts were randomized to either a four-session one-on-one school nurse-delivered smoking cessation intervention (37 schools, n = 571) or usual smoking cessation care control condition (34 schools, n = 577). Adolescents in grades 9-12 who smoked in the past 30 days completed surveys at baseline, 6 weeks and 3 months. The study was conducted during the 2002-2003 school year. RESULTS: Thirty-day self-reported abstinence rates were significantly greater in students in the intervention compared to control condition at 6 weeks (18% vs. 2%, respectively) and 3 months (24% vs. 5%, respectively). After adjusting for school and potential confounders, students in the intervention schools had odds of quitting 8 times greater than students in the control schools at 6 weeks (OR = 8.4; 95% CI 3.7, 20.6) and 6 times greater at 3 months (OR = 6.4; 95% CI 3.4, 11.4). School nurses delivered intervention with a high degree of fidelity. CONCLUSIONS: A four-session smoking cessation intervention can feasibly be delivered by school nurses and increase self-reported short-term abstinence rates among students interested in quitting smoking.     

四川某医学院校学生控烟课程干预效果评价

目的了解医学生控烟课程干预效果。方法在2013年3-6月在某医学院校对115名医学生实施控烟课程。在控烟课程实施前后,采用由中国控烟中心统一制作的问卷对医学生进行抽样调查。在描述性研究的基础上,采用χ2检验和秩和检验探讨控烟课程实施前后医学生在控烟态度及相关认知等方面的变化。结果控烟课程实施后,所调查学生的吸烟率由干预前的11.3%降为7.0%(P0.05);而且控烟态度更加明确(P0.05),尤其是在不可出售卷烟给青少年、应在舞厅酒吧游戏厅禁烟以及健康工作者应该成为病人或大众不吸烟的楷模三方面的态度很明确;在控烟课程实施后,不吸烟者对于将来自已肯定不会吸烟的态度更明确(P0.05),有超过90%的人认为控烟课程对今后的帮助有用,并且,有20%的人表示就目前所掌握的知识和技能能够帮助吸烟者戒烟。结论控烟课程提升了医学生的控烟态度及相关认知,能够帮助减少未来的吸烟者,可更广泛实施。     

护理专业学生控烟知识、态度、行为及控烟需求调查

目的 了解护理专业学生的控烟现状和需求,为在护理专业学生中开展控烟工作提供科学依据。方法 采用整群抽样的方法,对重庆市主城2所公立医学高等学校的5 382名在校护理专业学生进行问卷调查。结果 护理专业学生现在吸烟率4.3%,尝试吸烟率为22.6%,未来有吸烟意向者为13.2%;男生和女生吸烟行为有统计学差异。44.7%的护理专业学生否认低焦油、低尼古丁烟对身体危害小;14.3%知晓网吧应禁烟,11.3%知晓酒吧应禁烟。92.1%的学生反对恋人吸烟,85.3%的学生认为护理人员应该主动为病人提供戒烟服务。28.7%的学生向身边的人交流过烟草对健康的影响,45.2%学生劝过他人不吸烟。8.1%人表示在他们的劝说下,吸烟者戒烟了。护理专业学生获取控烟知识主要(73.3%)通过新闻媒体,75.4%的学生希望通过控烟教育获取戒烟方法相关知识。结论 护理专业学生的控烟相关知识知晓率低,参与控烟的积极性不高,建议对护理专业学生加强控烟责任感教育的同时,开展形式多样的控烟知识和技能培训。     

A study of the use of free nicotine patches by Indigenous people

OBJECTIVE: To assess use of free nicotine patches by Indigenous people when offered a brief intervention for smoking cessation, and to assess changes in smoking behaviour at six months. METHODS: We conducted a pre and post study in three Indigenous communities in the Northern Territory. RESULTS: Forty Indigenous smokers self-selected to receive free nicotine patches and a brief intervention for smoking cessation, and 71 chose the brief intervention only. Eighty-four per cent of participants were followed up; 14% of participants could not be located. Fifteen per cent of the nicotine patches group (10% with CO validation) and 1% (CO validated) of the brief intervention only group reported that they had quit at six months. Seventy-six per cent of the nicotine patches group and 51% of the brief intervention only group had reduced their consumption of tobacco. No participant completed a full course of patches. One possible side effect--the experience of bad dreams--was attributed in one community to the person concerned having been 'sung' or cursed. CONCLUSIONS: Free nicotine patches might benefit a small number of Indigenous smokers. Cessation rates for the use of both nicotine patches and brief intervention alone were lower than those in other populations, possibly because the study was conducted in a primary care setting and because of barriers to cessation such as widespread use of tobacco in these communities and the perception of tobacco use as non-problematic.     

益阳卫校职教生的吸烟习惯及其危险因素

目的探讨卫校职教生的吸烟习惯及危险因素,为学校控烟健康教育提供依据。方法采用自制问卷对益阳卫校职教3个专业共519名学生进行调查。结果医疗、卫生保健专业学生吸烟率分别为36.9%和48.8%,高于护士生的6.8%;男生吸烟率为69.7%,高于女生的6.8%。吸烟与烟草相关疾病知识贫乏、在校表现欠佳、不健康心理、家庭影响、伙伴影响等相关联(P<0.05)。结论由于内外因素的影响,职教生吸烟现象普遍,拒烟能力低。应采取应对措施,提高学生控烟能力。     

Tobacco use, exposure to secondhand smoke, and cessation counseling among health professions students: greek data from the global health professions student Survey (GHPSS)

We conducted the GHPSS (Global Health Professions Student Survey) to obtain information regarding health profession students' smoking habits and perceptions, exposure to secondhand smoke (SHS) as well as level of knowledge and training on tobacco use and smoking cessation counseling. GHPSS is a survey for third-year students in the following fields: health visitors, dentistry, medicine, nursing and/or pharmacy. The highest tobacco use prevalence rate and exposure to SHS were recorded among health visitor students with 46.4% and 33.3% respectively. The majority of the respondents believed that their profession serves as a role model for their patients. Formal training on cessation counseling ranged between 10.7% for health visitor students to 22.4% for nursing students. The relatively high percentage of health profession students who currently smoke and the alarmingly high percentage of those exposed to SHS indicate lack of concerted efforts for implementation and effective enforcement of the anti-tobacco policy measures. Despite its significance, formal training on cessation counseling for students is strikingly low. These results indicate the urgent need to train health professional students on tobacco cessation counseling and educate them on the dangers of tobacco use, SHS and the positively influential role they can play to affect their patients' smoking habits.