Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
BMC Public Health. 2018 Jan 30;18(1):194. doi: 10.1186/s12889-018-5105-6.
Smoking is a risk factor for several diseases. Physicians are role models for their patients. Physicians who smoke underestimate the health risks of smoking and may be less likely to offer advice to help their patients to quit. The aim of this study was to: provide an overview of smoking behaviour among Estonian physicians; assess the relationship between smoking and ischaemic heart disease (IHD), chronic bronchitis (CB), and lung emphysema (LE); and estimate fractions of prevalences of the three diseases attributable to smoking.
Self-administered questionnaires were sent to practising physicians (n = 5666) in Estonia in 2014. Prevalence of smoking and relative risks for IHD, CB and LE as well as the risks of IHD, CB and LE attributable to smoking were calculated by age and sex. Post-stratification was used to compensate non-response.
There were 535 male and 2404 female physicians participating. The prevalence of daily smoking was 12.4% (95% CI 10.4-14.4%) among men and 5.0% (95% CI 4.4-5.6%) among women. Mean duration of smoking among male and female daily smokers was 28.6 (95% CI 26.1-31.1) and 28.6 (95% CI 27.1-30.2) years. Compared to lifelong non-smokers, the age-adjusted risk for IHD was 1.29 times (95% CI 0.88-1.89) higher for men, but 1.69 times (95% CI 1.17-2.40) lower for all women who have ever smoked. The risk for CB was 2.29 (95% CI 1.30-4.03) times higher for smokers among men and, 1.32 (95% CI 0.95-1.82) among women; the risk ratio for LE was 4.92 (95% CI 1.14-21.1) among men and 2.45 (95% CI 0.63-9.52) among women. The smoking-attributable risk for IHD was 3.2% (95% CI 2.3-4.1%) among men and - 0.1% (95% CI -0.7-0.4%) among women; for CB 6.9% (95% CI 6.0-7.8%) and 4.2% (95% CI 3.5-4.8%); and for LE 18.8% (95% CI 17.0-22.5%) and 22.6% (95% CI 18.5-26.9%), respectively.
Prevalence of daily smoking was relatively low among Estonian physicians (and twice lower among female physicians). The risk attributable to smoking was higher for LE and CB than for IHD.
吸烟是多种疾病的危险因素。医生是患者的榜样。吸烟的医生低估了吸烟的健康风险，可能不太愿意提供帮助患者戒烟的建议。本研究的目的是：提供爱沙尼亚医生吸烟行为的概述；评估吸烟与缺血性心脏病（IHD）、慢性支气管炎（CB）和肺气肿（LE）之间的关系；并估计这三种疾病归因于吸烟的比例。
2014 年，向爱沙尼亚的执业医生（n=5666）发送了自我管理问卷。按年龄和性别计算吸烟流行率和 IHD、CB 和 LE 的相对风险，以及吸烟对 IHD、CB 和 LE 的归因风险。使用后分层来补偿无应答。
有 535 名男性和 2404 名女性医生参加。男性每日吸烟率为 12.4%（95%CI 10.4-14.4%），女性为 5.0%（95%CI 4.4-5.6%）。男性和女性每日吸烟者的平均吸烟年限分别为 28.6（95%CI 26.1-31.1）和 28.6（95%CI 27.1-30.2）年。与终生不吸烟者相比，男性 IHD 的年龄调整风险高 1.29 倍（95%CI 0.88-1.89），但所有吸烟女性的风险低 1.69 倍（95%CI 1.17-2.40）。吸烟者的 CB 风险高 2.29 倍（95%CI 1.30-4.03），女性为 1.32 倍（95%CI 0.95-1.82）；男性 LE 的风险比为 4.92（95%CI 1.14-21.1），女性为 2.45（95%CI 0.63-9.52）。IHD 的归因于吸烟的风险为 3.2%（95%CI 2.3-4.1%），女性为-0.1%（95%CI-0.7-0.4%）；CB 为 6.9%（95%CI 6.0-7.8%）和 4.2%（95%CI 3.5-4.8%）；LE 为 18.8%（95%CI 17.0-22.5%）和 22.6%（95%CI 18.5-26.9%）。
爱沙尼亚医生的每日吸烟率相对较低（女性医生的吸烟率低两倍）。与 IHD 相比，LE 和 CB 的归因于吸烟的风险更高。
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