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http://dx.doi.org/10.3961/jpmph.15.061

Assessment of Tobacco Habits, Attitudes, and Education Among Medical Students in the United States and Italy: A Cross-sectional Survey  

Armstrong, Grayson W. (Massachusetts Eye and Ear Infirmary/Harvard Medical School)
Veronese, Giacomo (Department of Medical and Surgical Sciences, University of Bologna)
George, Paul F. (The Warren Alpert Medical School of Brown University)
Montroni, Isacco (Department of Medical and Surgical Sciences, University of Bologna)
Ugolini, Giampaolo (Department of Medical and Surgical Sciences, University of Bologna)
Publication Information
Journal of Preventive Medicine and Public Health / v.50, no.3, 2017 , pp. 177-187 More about this Journal
Abstract
Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
Keywords
Tobacco use cessation; Medical education; Medical student; Smoking;
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1 World Health Organization. Tobacco fact sheet; 2016 Jun 21 [cited 2017 May 13]. Available from: http://www.wpro.who.int/mediacentre/factsheets/fs_201203_tobacco/en/.
2 US Department of Health and Human Services. The health consequences of smoking: 50 years of progress: a report of the Surgeon General; 2014 [cited 2015 Oct 3]. Available from: https://www.surgeongeneral.gov/library/reports/50-yearsof-progress/full-report.pdf.
3 Gallus S, Muttarak R, Martinez-Sanchez JM, Zuccaro P, Colombo P, La Vecchia C. Smoking prevalence and smoking attributable mortality in Italy, 2010. Prev Med 2011;52(6):434-438.   DOI
4 Tomar SL, Husten CG, Manley MW. Do dentists and physicians advise tobacco users to quit? J Am Dent Assoc 1996;127(2):259-265.   DOI
5 US Department of Health and Human Services. Reducing tobacco use: a report of the Surgeon General; 2000 [cited 2015 Oct 3]. Available from: https://www.cdc.gov/tobacco/data_statistics/sgr/2000/complete_report/pdfs/fullreport.pdf.
6 US Department of Health and Human Services. Treating tobacco use and dependence; 2000 [cited 2015 Oct 3]. Available from: http://whyquit.com/pharmacology/June2000Guideline.pdf.
7 Lim G, Park I, Park S, Song S, Kim H, Kim S. Effectiveness of smoking cessation using motivational interviewing in patients consulting a pulmonologist. Tuberc Respir Dis (Seoul) 2014;76(6):276-283.   DOI
8 Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2013;(5):CD000165.
9 Roman B, Borges N, Morrison AK. Teaching motivational interviewing skills to third-year psychiatry clerkship students. Acad Psychiatry 2011;35(1):51-53.   DOI
10 Powers CA, Zapka J, Biello KB, O'Donnell J, Prout M, Geller A. Cultural competency and tobacco control training in US medical schools: many but missed opportunities. J Cancer Educ 2010;25(3):290-296.   DOI
11 Leone FT, Evers-Casey S, Veloski J, Patkar AA, Kanzleiter L; Pennsylvania Continuum of Tobacco Education Work Group. Short-, intermediate-, and long-term outcomes of Pennsylvania's continuum of tobacco education pilot project. Nicotine Tob Res 2009;11(4):387-393.   DOI
12 Centers for Disease Control and Prevention (CDC). Tobacco use and cessation counseling--global health professionals survey pilot study, 10 countries, 2005. MMWR Morb Mortal Wkly Rep 2005;54(20):505-509.
13 Richmond R, Zwar N, Taylor R, Hunnisett J, Hyslop F. Teaching about tobacco in medical schools: a worldwide study. Drug Alcohol Rev 2009;28(5):484-497.   DOI
14 Ferketich AK, Gallus S, Colombo P, Apolone G, Rossi S, Zuccaro P, et al. Use of pharmacotherapy while attempting cessation among Italian smokers. Eur J Cancer Prev 2009;18(1):90-92.   DOI
15 La Torre G, Sandstrom P, Falkenberg M, Tanskanen P, Patja K, Kauhanen J. Smoking prevention and smoking cessation training in European medical schools. Eur J Public Health 2009;19(Suppl 1):10-127.   DOI
16 Grassi MC, Chiamulera C, Baraldo M, Culasso F, Ferketich AK, Raupach T, et al. Cigarette smoking knowledge and perceptions among students in four Italian medical schools. Nicotine Tob Res 2012;14(9):1065-1072.   DOI
17 Ferketich AK, Gallus S, Colombo P, Fossati R, Apolone G, Zuccaro P, et al. Physician-delivered advice to quit smoking among Italian smokers. Am J Prev Med 2008;35(1):60-63.   DOI
18 Hung DY, Leidig R, Shelley DR. What's in a setting?: Influence of organizational culture on provider adherence to clinical guidelines for treating tobacco use. Health Care Manage Rev 2014;39(2):154-163.   DOI
19 Nobile CG, Bianco A, Biafore AD, Manuti B, Pileggi C, Pavia M. Are primary care physicians prepared to assist patients for smoking cessation? Results of a national Italian cross-sectional web survey. Prev Med 2014;66:107-12.   DOI
20 Springer CM, Tannert Niang KM, Matte TD, Miller N, Bassett MT, Frieden TR. Do medical students know enough about smoking to help their future patients? Assessment of New York City fourth-year medical students' knowledge of tobacco cessation and treatment for nicotine addiction. Acad Med 2008;83(10):982-989.   DOI
21 Kruger J, O'Halloran A, Rosenthal A. Assessment of compliance with U.S. Public Health Service clinical practice guideline for tobacco by primary care physicians. Harm Reduct J 2015;12:7.   DOI
22 Smith DR, Leggat PA. An international review of tobacco smoking among medical students. J Postgrad Med 2007;53(1):55-62.   DOI
23 Gordon JS, Mahabee-Gittens EM, Andrews JA, Christiansen SM, Byron DJ. A randomized clinical trial of a web-based tobacco cessation education program. Pediatrics 2013;131(2):e455-e462.   DOI
24 Mangus RS, Hawkins CE, Miller MJ. Tobacco and alcohol use among 1996 medical school graduates. JAMA 1998;280(13):1192-1195.   DOI
25 Saulle R, Bontempi C, Baldo V, Boccia G, Bonaccorsi G, Brusaferro S, et al. GHPSS multicenter Italian survey: smoking prevalence, knowledge and attitudes, and tobacco cessation training among third-year medical students. Tumori 2013;99(1):17-22.   DOI
26 Ng M, Freeman MK, Fleming TD, Robinson M, Dwyer-Lindgren L, Thomson B, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014;311(2):183-192.   DOI
27 Raupach T, Shahab L, Baetzing S, Hoffmann B, Hasenfuss G, West R, et al. Medical students lack basic knowledge about smoking: findings from two European medical schools. Nicotine Tob Res 2009;11(1):92-98.   DOI
28 Frank E, Elon L, Spencer E. Personal and clinical tobacco-related practices and attitudes of U.S. medical students. Prev Med 2009;49(2-3):233-239.   DOI
29 Centers for Disease Control and Prevention (CDC). Smoking control among health-care workers--World No-Tobacco Day, 1993. MMWR Morb Mortal Wkly Rep 1993;42(19):365-367.
30 Garfinkel L. Cigarette smoking among physicians and other health professionals, 1959-1972. CA Cancer J Clin 1976;26(6):373-375.   DOI
31 American Nonsmokers' Rights Foundation. Smokefree and tobacco-free U.S. and tribal colleges and universities [cited 2016 Dec 29]. Available from: http://senate.rutgers.edu/Smoke-FreeUniversitiesList.pdf.