Borum M L
Department of Medicine, George Washington University Medical Center, Washington, DC 20037, USA.
J Natl Med Assoc. 2000 Mar;92(3):131-5.
Tobacco use causes significant morbidity and mortality among African Americans. Physicians may inconsistently counsel patients against smoking. This retrospective chart review evaluated smoking cessation efforts in African Americans by internal medicine resident physicians in a traditional and a primary care residency program. One hundred twenty-nine African-American patients were evaluated by resident physicians in the traditional internal medicine residency. A tobacco use history was obtained in 84 patients. Twenty-eight patients smoked and two patients were counseled against smoking. Fifty-two African-American patients were evaluated by resident physicians in the primary care residency. A tobacco use history was obtained in 47 patients. Twenty patients smoked and 12 patients were counseled against smoking. There was a statistically significant difference in the rate at which smoking histories were obtained (p = 0.0011) and frequency of counseling against smoking (p < 0.0001). Gender analysis revealed that African-American women were less frequently asked about their smoking history (p = 0.0058) and counseled against smoking (p = 0.0016) by resident physicians in the traditional residency. African-American men received less counseling against smoking (p = 0.055) by resident physicians in the traditional residency. Resident physicians in the primary care residency program demonstrated greater smoking cessation efforts for African American patients. Smoking cessation should be emphasized in all internal medicine residency training programs.
吸烟在非裔美国人中导致了大量的发病和死亡。医生在为患者提供戒烟建议时可能并不一致。这项回顾性图表审查评估了传统内科住院医师培训项目和初级保健住院医师培训项目中的内科住院医师针对非裔美国人的戒烟工作。传统内科住院医师培训项目中的住院医师评估了129名非裔美国患者。84名患者提供了吸烟史。28名患者吸烟,其中2名患者接受了戒烟建议。初级保健住院医师培训项目中的住院医师评估了52名非裔美国患者。47名患者提供了吸烟史。20名患者吸烟,其中12名患者接受了戒烟建议。在获取吸烟史的比例(p = 0.0011)和提供戒烟建议的频率(p < 0.0001)方面存在统计学上的显著差异。性别分析显示,在传统住院医师培训项目中,住院医师较少询问非裔美国女性的吸烟史(p = 0.0058),并较少为她们提供戒烟建议(p = 0.0016)。在传统住院医师培训项目中,住院医师为非裔美国男性提供的戒烟建议也较少(p = 0.055)。初级保健住院医师培训项目中的住院医师为非裔美国患者做出了更大的戒烟努力。所有内科住院医师培训项目都应强调戒烟。