Panda Rajmohan, Persai Divya, Mathur Manu, Sarkar Bidyut Kanti
Public Health Foundation of India, New Delhi, India E-mail : raj.
Asian Pac J Cancer Prev. 2013;14(12):7237-41. doi: 10.7314/apjcp.2013.14.12.7237.
Smokeless tobacco use in South Asia is believed to be a significant contributor to morbidity and mortality. In India, only a few studies involving health educational intervention by health care providers have demonstrated reduction in smokeless tobacco usage. In the present study we assessed the cessation efforts towards smokeless tobacco by physicians in two high tobacco prevalence states of India. The study also identified opportunities and barriers for integration of tobacco cessation services in routine practices of physicians.
This mixed method study involved qualitative (phase I) and quantitative research study (phase II). In phase I, 59 in-depth interviews with physicians were conducted. In phase II, a quantitative study conducted among 238 physicians. An inductive approach was followed to analyze qualitative data using ATLAS. Ti software. The Chi-square test was employed to test the association between different variables of interest using SPSS version 17.
The majority of physicians related only respiratory problems and cancer with smokeless tobacco. Other major health effects like cardio-vascular problems, oral diseases, and effects on reproductive and neonatal health were recognized only by a few physicians. The age-group of 10-19 years was identified as most vulnerable to smokeless tobacco use. Less than one-third of physicians reported recording smokeless tobacco history of all patients. Findings indicated that less than half of physicians provided information on harmful health effects of smokeless tobacco with regard to specific diseases.
The study revealed a low level of knowledge of physicians about harmful effects of tobacco and their suboptimal engagement in tobacco control practices. The study indicates the need of capacity building initiatives to equip physicians with skills in tobacco cessation.
南亚地区使用无烟烟草被认为是导致发病和死亡的一个重要因素。在印度，仅有少数涉及医疗保健提供者进行健康教育干预的研究表明无烟烟草的使用有所减少。在本研究中，我们评估了印度两个烟草高流行邦的医生针对无烟烟草的戒烟工作。该研究还确定了在医生的日常工作中整合戒烟服务的机会和障碍。
这项混合方法研究包括定性研究（第一阶段）和定量研究（第二阶段）。在第一阶段，对医生进行了59次深入访谈。在第二阶段，对238名医生进行了定量研究。采用归纳法，使用ATLAS.ti软件分析定性数据。使用SPSS 17版软件，采用卡方检验来检验不同感兴趣变量之间的关联。
大多数医生仅将呼吸系统问题和癌症与无烟烟草联系起来。只有少数医生认识到其他主要健康影响，如心血管问题、口腔疾病以及对生殖和新生儿健康的影响。10 - 19岁年龄组被确定为最易使用无烟烟草的群体。不到三分之一的医生报告记录了所有患者的无烟烟草使用史。研究结果表明，不到一半的医生提供了关于无烟烟草对特定疾病有害健康影响的信息。
该研究揭示了医生对烟草有害影响的了解程度较低，以及他们在烟草控制实践中的参与度欠佳。该研究表明需要开展能力建设举措，使医生具备戒烟技能。
