Armstrong Grayson W, Veronese Giacomo, George Paul F, Montroni Isacco, Ugolini Giampaolo
Massachusetts Eye and Ear Infirmary/Harvard Medical School, Boston, MA, USA.
J Prev Med Public Health. 2017;50(3):177-187. doi: 10.3961/jpmph.15.061.
Medical students represent a primary target for tobacco cessation training. This study assessed the prevalence of medical students' tobacco use, attitudes, clinical skills, and tobacco-related curricula in two countries, the US and Italy, with known baseline disparities in hopes of identifying potential corrective interventions.
From September to December 2013, medical students enrolled at the University of Bologna and at Brown University were recruited via email to answer survey questions assessing the prevalence of medical students' tobacco use, attitudes and clinical skills related to patients' smoking, and elements of medical school curricula related to tobacco use.
Of the 449 medical students enrolled at Brown and the 1426 enrolled at Bologna, 174 Brown students (38.7%) and 527 Bologna students (36.9%) participated in this study. Italian students were more likely to smoke (29.5% vs. 6.1%; p<0.001) and less likely to receive smoking cessation training (9.4% vs. 80.3%; p<0.001) than their American counterparts, even though the majority of students in both countries desired smoking cessation training (98.6% at Brown, 85.4% at Bologna; p<0.001). Additionally, negative beliefs regarding tobacco usage, the absence of formal training in smoking cessation counseling, and a negative interest in receiving specific training on smoking cessation were associated with a higher risk of not investigating a patient's smoking status during a routine history and not offering tobacco cessation treatment to patients.
Medical curricula on tobacco-related health hazards and on smoking cessation should be mandatory in order to reduce smoking among medical students, physicians, and patients, thereby improving tobacco-related global health.
医学生是戒烟培训的主要目标群体。本研究评估了美国和意大利这两个已知存在基线差异的国家医学生的烟草使用情况、态度、临床技能以及与烟草相关的课程,以期确定潜在的纠正干预措施。
2013年9月至12月,通过电子邮件招募了博洛尼亚大学和布朗大学的医学生,让他们回答调查问卷,评估医学生的烟草使用情况、与患者吸烟相关的态度和临床技能,以及医学院与烟草使用相关的课程内容。
在布朗大学入学的449名医学生和博洛尼亚大学入学的1426名医学生中,分别有174名布朗大学学生(38.7%)和527名博洛尼亚大学学生(36.9%)参与了本研究。与美国学生相比,意大利学生吸烟的可能性更高(29.5%对6.1%;p<0.001),接受戒烟培训的可能性更低(9.4%对80.3%;p<0.001),尽管两国的大多数学生都希望接受戒烟培训(布朗大学为98.6%,博洛尼亚大学为85.4%;p<0.001)。此外,对烟草使用的负面信念、缺乏戒烟咨询的正规培训以及对接受戒烟特定培训的消极态度,与在常规病史询问中不调查患者吸烟状况以及不向患者提供戒烟治疗的较高风险相关。
应强制开设与烟草相关健康危害和戒烟相关的医学课程,以减少医学生、医生和患者中的吸烟行为,从而改善与烟草相关的全球健康状况。