Mughal Faraz, Rashid Ahmed, Jawad Mohammed
1GP & Honorary Research Fellow,Unit of Academic Primary Care,Warwick Medical School,University of Warwick,Coventry,UK.
3UCL Medical School,Royal Free Hospital,Hampstead,London,UK.
Prim Health Care Res Dev. 2018 Nov;19(6):605-609. doi: 10.1017/S1463423618000166. Epub 2018 Jun 8.
Little is known around how general practitioners (GP) approach tobacco products beyond traditional cigarettes.AimTo examine GP perceptions of tobacco and electronic cigarette (EC) products, and their attitudes and behaviours towards product cessation.
A 13-item self-completed anonymous questionnaire measured awareness of waterpipe tobacco smoking (WTS) and smokeless tobacco (ST). Cessation advice provision, referral to cessation services, and the harm perception of these products were asked using five-point Likert scales that were dichotomised on analysis. Correlates of cessation advice were analysed using regression models.FindingsWe analysed 312 responses, of whom 63% were aware of WTS and between 5-32% were aware of ST products. WTS and ST were considered less harmful than cigarettes by 82 and 68% of GPs, respectively. WTS, ST, and EC users were less advised (P<0.001) and referred (P<0.001) to cessation services compared to cigarette users. Ethnic minority and senior GPs were more likely to provide cessation advice for WTS and ST users compared to younger white GPs. GPs who were recent tobacco users were less likely to give cessation advice to cigarette users (adjusted odds ratios 0.17, 95% confidence interval 0.03-0.99, P<0.049).Conclusions (implications for practice and research)GPs had lower harm perception, gave less cessation advice, and made less referrals for WTS and ST users compared to cigarettes. Our findings highlight the need for targeted tobacco education in general practice. More research is needed to explore GP perceptions in depth as well as patient perspectives.
对于全科医生（GP）如何看待传统香烟以外的烟草产品，我们知之甚少。
研究全科医生对烟草和电子烟（EC）产品的看法，以及他们对产品戒烟的态度和行为。
一份包含13个项目的自填式匿名问卷，用于测量对水烟吸烟（WTS）和无烟烟草（ST）的认知。使用五点李克特量表询问戒烟建议的提供、转介至戒烟服务以及对这些产品的危害认知，在分析时将其进行二分法处理。使用回归模型分析戒烟建议的相关因素。
我们分析了312份回复，其中63%知晓水烟吸烟，5%-32%知晓无烟烟草产品。分别有82%和68%的全科医生认为水烟吸烟和无烟烟草比香烟危害小。与香烟使用者相比，水烟吸烟、无烟烟草和电子烟使用者接受戒烟建议（P<0.001）和转介至戒烟服务（P<0.001）的比例更低。与年轻的白人全科医生相比，少数族裔和资深全科医生更有可能为水烟吸烟和无烟烟草使用者提供戒烟建议。近期使用烟草的全科医生为香烟使用者提供戒烟建议的可能性较小（调整后的优势比为0.17，95%置信区间为0.03-0.99，P<0.049）。
结论（对实践和研究的启示）：与香烟相比，全科医生对水烟吸烟和无烟烟草使用者的危害认知较低，提供的戒烟建议较少，转介也较少。我们的研究结果凸显了在全科医疗中开展针对性烟草教育的必要性。需要更多研究来深入探讨全科医生的看法以及患者的观点。
