Changes in the smoking behaviour, knowledge and opinion of medical students, 1972-1981.

To examine changes in medical students' smoking behaviour, knowledge and opinion over the last decade, a survey first conducted at the University of Manchester Medical School in 1972 was repeated in 1981. A postal questionnaire was sent to 1163 students, of whom 1112 (96%) replied. A substantial decline in cigarette smoking among medical students has occurred. This largely follows trends in the general population, medical education itself having made little contribution to the change. In 1972, 29% of students were cigarette smokers compared with 17% in 1981. The fall in cigarette smoking was more marked among men students rather than women, older rather than younger students, clinical rather than pre-clinical students. Cigarette consumption had also decreased as had the use of cigars and pipes among male students. The decline was already evident prior to students beginning their medical studies. A smaller expansion of smoking experience at medical school had occurred among the 1981 students, but, as in 1972, those who took up smoking or increased their consumption exceeded those who gave up or cut down. In 1981 the likelihood of taking up smoking or becoming a regular smoker at medical school was somewhat greater for women students than for men, although the numbers concerned were small. The survey reconfirmed the importance of the social environment in smoking behaviour. Modest changes had occurred in knowledge and opinion about smoking. Both the accuracy and scope of knowledge of students about the health hazards increased between 1972 and 1981, particularly among clinical students, who remained considerably better informed than their pre-clinical colleagues. As in 1972, knowledge had little impact on smoking behaviour. By 1981 nine out of ten students regarded smoking as a major risk to health, both clinical students and smokers being more likely to take this view than in 1972. Almost all students, irrespective of their smoking behaviour, found the evidence linking smoking to serious illness to some extent convincing, and by 1981 a somewhat greater proportion, 60%, found it very convincing, the tendency to do so increasing as they progressed through their course.