Chatkin J, Chatkin G
Faculdade de Medicina da Pontifícia Universidade Católica do Rio Grande Sul (PUCRS), Porto Alegre, Brazil.
Int J Tuberc Lung Dis. 2009 Apr;13(4):429-37.
Despite the accumulation of evidence about the risks of tobacco use in recent decades, smoking remains an important public health problem. Although significant advances for its control have been achieved, the role of health care workers, especially physicians, is still less than ideal, as smoking cessation could provide great benefits to their patients. In many countries, these professionals fail to be proactive in promoting smoking cessation: they do not motivate their patients, offer options for quitting smoking or help prevent smoking initiation among adolescents. This reluctance clearly signifies lost opportunities in the fight against smoking, much as in the days before the harmful effects of smoking were well-defined. Given that about 70% of smokers seek medical assistance over the course of a year due to problems both related and unrelated to smoking, the percentage of wasted possibilities remains significant. This may occur because physicians feel insecure in addressing the various problems when communicating with smokers. The aim of this article is to review the reasons for insufficient commitment of some physicians to this fight. We attribute part of the problem to deficiencies in medical school education, insufficient training, not adapting medical school curricula to the rapid changes occurring in this area and a lack of transdisciplinary vision regarding smoking. All are possibilities that can explain such lost opportunities in treating smokers.
尽管近几十年来已有大量证据表明吸烟存在风险，但吸烟仍是一个重要的公共卫生问题。虽然在控烟方面已取得重大进展，但医护人员，尤其是医生，在这方面的作用仍不尽如人意，因为戒烟能给患者带来巨大益处。在许多国家，这些专业人员未能积极主动地促进戒烟：他们没有激励患者，没有提供戒烟选择，也没有帮助预防青少年开始吸烟。这种不情愿显然意味着在与吸烟作斗争中错失了机会，就如同在吸烟的有害影响尚未明确界定的过去一样。鉴于约70%的吸烟者因与吸烟相关或无关的问题在一年中寻求医疗帮助，被浪费的可能性比例仍然很大。这可能是因为医生在与吸烟者沟通时处理各种问题时感到不自信。本文旨在探讨一些医生在这场斗争中投入不足的原因。我们认为部分问题在于医学院校教育存在缺陷、培训不足、医学院课程未能适应该领域的快速变化以及缺乏关于吸烟的跨学科视野。所有这些都有可能解释在治疗吸烟者方面出现的此类错失机会的情况。
