Ravara Sofia B, Castelo-Branco Miguel, Aguiar Pedro, Calheiros Jose M
Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Av, Infante D, Henrique, 6200-506 Covilha, Portugal.
BMC Public Health. 2014 Sep 20;14:979. doi: 10.1186/1471-2458-14-979.
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.
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.
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.
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.
医生在烟草控制（TC）中的关键作用已得到广泛认可。2008年，葡萄牙实施了一项非全面的无烟政策（SFP）。2009年，开展了一项会议调查，通过评估以下方面来探究葡萄牙医生对烟草控制的参与情况：1）参加烟草控制培训及对培训需求的认知；2）参与烟草控制活动；3）对无烟政策的态度和信念。
在两次主要的全国性医学会议期间针对全科医生、住院医生以及学生/刚毕业的学生开展了基于问卷调查的横断面研究。进行了描述性分析和逻辑回归分析。
回复率为63.7%（605/950）。在605名参与者中，58.3%为全科医生，32.4%为住院医生，9.3%为其他人员；62.6%为女性；平均年龄为39.0±12.9岁。男性吸烟率为29.2%（95%置信区间：23.3 - 35.1）；女性为15.8%（95%置信区间：12.1 - 19.5），p < 0.001。虽然绝大多数医生强烈认同二手烟（SHS）危害健康，但对无烟政策益处和烟草控制法律的认知有限，p < 0.001。相当一部分少数人（35.5%）认为通风系统可以消除二手烟。大多数医生缺乏培训；只有少数人（9.0%）定期参与烟草控制。培训是参与烟草控制最一致的预测因素。对无烟政策的总体认同度较高；但在室内休闲场所、医疗保健/学校场所的户外禁烟以及家庭/车内吸烟限制方面显著较低，p < 0.001。吸烟行为强烈预测了对餐厅、酒吧/迪斯科舞厅、户外医疗保健场所和私人场所吸烟限制的支持。
研究结果表明，葡萄牙医生未意识到他们在烟草控制中的作用。医生对烟草控制参与度低可能导致葡萄牙和欧洲目前缺乏全面政策，并破坏社会规范的改变。应将烟草控制方面的医学和专业继续教育作为首要任务。
