Bostan Pinar Pazarli, Demir Canan Karaman, Elbek Osman, Akçay Şule
School of Health, Sakarya University, Sakarya, Turkey.
Occupational Diseases Education Clinic, Ankara Atatürk Chest Diseases and Thoracic Surgery Training Hospital, Ankara, Turkey.
BMC Pulm Med. 2015 Nov 11;15:143. doi: 10.1186/s12890-015-0131-y.
A strategy to reduce the number of smoking-related deaths is to encourage the involvement of health-care professionals in tobacco-use prevention activities and cessation counseling. Previous studies have shown that physicians' smoking status affects their efforts to provide smoking cessation counseling. This study investigates the association between pulmonologists' tobacco use and their efforts in promoting smoking cessation during their routine clinical practices in Turkey.
This cross-sectional study was performed among active members of the Turkish Thoracic Society (TTS) between June 2010 and February 2011 using an Internet-based self-administered questionnaire. Participants gave their written informed consent. The survey included questions about responders' sociodemographics, smoking status, and their routine clinical practice for smoking cessation counseling using the basic 5A's (Ask, Advise, Assess, Assist, and Arrange) of smoking cessation counseling. According to the total score for the 5A's protocol, smoking cessation counseling was dichotomized into low- and high-effort groups in promoting smoking cessation. Pearson's chi-square test and t-test were used to compare groups and logistic regression models for the research question, which was approved by the TTS Scientific Ethical Committee.
The response rate was 41 % (N = 699/1701); 9.9 % were current smokers, and 72.7 % indicated that they provided high effort in promoting smoking cessation. A univariate analysis showed that noncurrent smokers were more likely to make a high effort than current smokers (odds ratio [OR], 1.82; 95 % confidence interval [CI]: 1.09-3.05; P = 0.02). However, there was no association between tobacco use (current smoking) and making high effort in promoting smoking cessation after controlling for the two confounders, sex and practicing in smoking cessation outpatient clinic (OR, 1.47; 95 % CI: 0.86-2.50; P = 0.1).
Despite low response rate in our study and suspicions of underreporting, the smoking rate among the pulmonologists in our study was high. Non-current smokers were more likely to provide high effort in promoting smoking cessation compared to current smokers in univariate analysis. However, after controlling for the two confounders, sex and practising in SCOC, there was no association between tobacco use and providing high effort in promoting smoking cessation. Thus, improving medical school education, specialty training and post-graduate training on smoking cessation counseling may positively affect physician' effort in promoting smoking cessation.
减少吸烟相关死亡人数的一项策略是鼓励医护人员参与烟草使用预防活动和戒烟咨询。既往研究表明，医生的吸烟状况会影响他们提供戒烟咨询的努力程度。本研究调查了土耳其肺科医生的烟草使用情况与其在日常临床实践中促进戒烟努力之间的关联。
这项横断面研究于2010年6月至2011年2月期间在土耳其胸科协会（TTS）的在职成员中进行，采用基于互联网的自填式问卷。参与者给予了书面知情同意。该调查包括有关应答者的社会人口统计学、吸烟状况以及他们使用戒烟咨询基本5A法（询问、建议、评估、协助和安排）进行戒烟咨询的日常临床实践的问题。根据5A法方案的总分，将戒烟咨询分为促进戒烟的低努力组和高努力组。使用Pearson卡方检验和t检验比较组间差异，并使用逻辑回归模型分析研究问题，该研究经TTS科学伦理委员会批准。
应答率为41%（N = 699/1701）；9.9%为当前吸烟者，72.7%表示他们在促进戒烟方面付出了很大努力。单因素分析显示，非当前吸烟者比当前吸烟者更有可能付出很大努力（优势比[OR]，1.82；95%置信区间[CI]：1.09 - 3.05；P = 0.02）。然而，在控制了性别和在戒烟门诊工作这两个混杂因素后，烟草使用（当前吸烟）与在促进戒烟方面付出很大努力之间没有关联（OR，1.47；95% CI：0.86 - 2.50；P = 0.1）。
尽管我们的研究应答率较低且存在报告不足的疑虑，但我们研究中肺科医生的吸烟率较高。在单因素分析中，非当前吸烟者比当前吸烟者更有可能在促进戒烟方面付出很大努力。然而，在控制了性别和在戒烟门诊工作这两个混杂因素后，烟草使用与在促进戒烟方面付出很大努力之间没有关联。因此，改善医学院校教育、专科培训和关于戒烟咨询的研究生培训可能会对医生在促进戒烟方面的努力产生积极影响。
