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Lin Y, Huang Y, Xi X. Association between lifestyle behaviors and health-related quality of life among primary health care physicians in China: A cross-sectional study. Front Public Health 2023; 11:1131031. [PMID: 36969630 PMCID: PMC10030863 DOI: 10.3389/fpubh.2023.1131031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/16/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundPrimary health care (PHC) serves as the gatekeeper of health system and PHC physicians take on significant obligations to provide health care services in the pursuit of Universal Health Coverage (UHC). PHC physicians' health-related quality of life (HRQoL) can have a strong impact on patients, physicians and the health care system. Lifestyle interventions are found to be effective to improve HRQoL. The purpose of this study was to evaluate the association between lifestyle behaviors and HRQoL among PHC physicians, so that lifestyle intervention can be tailored by policy makers for health promotion.MethodsA survey covering 31 provinces and administrative regions in China was conducted in 2020 using a stratified sampling strategy. Data on sociodemographic characteristics lifestyle behaviors and HRQoL were collected by a self-administered questionnaire. HRQoL was measured through EuroQol-five dimension-five level (EQ-5D-5L) instrument. A Tobit regression model was performed to evaluate the association between sociodemographic characteristics, lifestyle behaviors and HRQoL.ResultsAmong 894 PHC physicians who completed the survey, Anxiety/Depression (AD) was the dimension with the most problems reported (18.1%). Regular daily routine (β = 0.025, 95%CI 0.004 to 0.045) and good sleep quality (β = 0.049, 95% CI = 0.029 to 0.069) were protective factors for HRQoL, while smoking (β = −0.027, 95% CI = −0.079 to −0.003) and frequency of eating breakfast (β = −0.041, 95%CI = −0.079 to −0.003) were negatively associated with HRQoL. Physical activity and alcohol drinking were not significantly associated with HRQoL.ConclusionThese findings suggest that tailored interventions on daily routine, improving sleep quality, and tobacco control among PHC physicians may be effective strategies to improve their HRQoL.
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Besson A, Tarpin A, Flaudias V, Brousse G, Laporte C, Benson A, Navel V, Bouillon-Minois JB, Dutheil F. Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413328. [PMID: 34948936 PMCID: PMC8705497 DOI: 10.3390/ijerph182413328] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. METHODS PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. RESULTS Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. CONCLUSION Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.
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Affiliation(s)
- Anaïs Besson
- Family Medicine, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (A.B.); (A.T.)
| | - Alice Tarpin
- Family Medicine, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (A.B.); (A.T.)
| | - Valentin Flaudias
- Univ Angers, Laboratoire de psychologie des Pays de la Loire, Université de Nantes, LPPL, EA 4638, F-44000 Nantes, France;
| | - Georges Brousse
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont–Ferrand, France; (G.B.); (C.L.)
| | - Catherine Laporte
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont–Ferrand, France; (G.B.); (C.L.)
| | - Amanda Benson
- Sport Innovation Research Group, Department of Health and Biostatistics, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
| | - Valentin Navel
- CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Jean-Baptiste Bouillon-Minois
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Emergency Medicine, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Correspondence: ; Tel.: +33-6-74-36-04-23; Fax: +33-4-73-27-46-49
| | - Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, F-63000 Clermont-Ferrand, France;
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Warsi S, Elsey H, Boeckmann M, Noor M, Khan A, Barua D, Nasreen S, Huque S, Huque R, Khanal S, Shrestha P, Newell J, Dogar O, Siddiqi K. Using behaviour change theory to train health workers on tobacco cessation support for tuberculosis patients: a mixed-methods study in Bangladesh, Nepal and Pakistan. BMC Health Serv Res 2019; 19:71. [PMID: 30683087 PMCID: PMC6347762 DOI: 10.1186/s12913-019-3909-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 01/15/2019] [Indexed: 12/25/2022] Open
Abstract
Background Low- and middle-income countries (LMICs) are disproportionately impacted by interacting epidemics of tuberculosis (TB) and tobacco consumption. Research indicates behavioural support delivered by health workers effectively promotes tobacco cessation. There is, however, a paucity of training to support LMIC health workers deliver effective tobacco cessation behavioural support. The TB and Tobacco Consortium undertook research in South Asia to understand factors affecting TB health workers’ delivery of tobacco cessation behavioural support, and subsequently developed a training package for LMICs. Methods Using the “capability, opportunity, and motivation as determinants of behaviour” (COM-B) framework to understand any issues facing health worker delivery of behaviour support, we analysed 25 semi-structured interviews and one focus group discussion with TB health workers, facility in-charges, and national tuberculosis control programme (NTP) staff members in each country. Results were integrated with findings of an adapted COM-B questionnaire on health worker confidence in tobacco cessation support delivery, administered to 36 TB health workers. Based on findings, we designed a guide and training programme on tobacco cessation support for health workers. Results Qualitative results highlighted gaps in the majority of health workers’ knowledge on tobacco cessation and TB and tobacco interaction, inadequate training on patient communication, insufficient resources and staff support, and NTPs’ non-prioritization of tobacco cessation in all three countries. Questionnaire results reiterated the knowledge deficits and low confidence in patient communication. Participants suggested strengthening knowledge, skills, and competence through training and professional incentives. Based on findings, we developed an interactive two-day training and TB health worker guide adaptable for LMICs, focusing on evidence of best practice on TB and tobacco cessation support, communication, and rapport building with patients. Conclusions TB health workers are essential in addressing the dual burden of TB and tobacco faced by many LMICs. Factors affecting their delivery of tobacco cessation support can be identified using the COM-B framework, and include issues such as individuals’ knowledge and skills, as well as structural barriers like professional support through monitoring and supervision. While structural changes are needed to tackle the latter, we have developed an adaptable and engaging health worker training package to address the former that can be delivered in routine TB care. Trial registration ISRCTN43811467. Electronic supplementary material The online version of this article (10.1186/s12913-019-3909-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sahil Warsi
- Leeds Institute of Health Sciences, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK
| | - Helen Elsey
- Leeds Institute of Health Sciences, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
| | - Melanie Boeckmann
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Werdener Str. 4, 40227, Düsseldorf, Germany
| | - Maryam Noor
- The Initiative, Orange Grove Farm, Banigala, Islamabad, Pakistan
| | - Amina Khan
- The Initiative, Orange Grove Farm, Banigala, Islamabad, Pakistan
| | - Deepa Barua
- ARK Foundation, House B130, Road 21, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh
| | - Shammi Nasreen
- ARK Foundation, House B130, Road 21, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh
| | - Samina Huque
- ARK Foundation, House B130, Road 21, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh
| | - Rumana Huque
- ARK Foundation, House B130, Road 21, New DOHS, Mohakhali, Dhaka, 1206, Bangladesh
| | - Sudeepa Khanal
- HERD International, P O Box Number: 24144, Thapathali 11, Kathmandu, Nepal
| | - Prabin Shrestha
- HERD International, P O Box Number: 24144, Thapathali 11, Kathmandu, Nepal
| | - James Newell
- Leeds Institute of Health Sciences, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK
| | - Omara Dogar
- The Hull York Medical School, University of York, York, YO10 5DD, UK
| | - Kamran Siddiqi
- The Hull York Medical School, University of York, York, YO10 5DD, UK
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Mizher IY, Fawaqa SI, Sweileh WM. Prevalence and personal attitudes towards tobacco smoking among Palestinian healthcare professionals: a cross-sectional study. Addict Sci Clin Pract 2018; 13:17. [PMID: 30053911 PMCID: PMC6063017 DOI: 10.1186/s13722-018-0119-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/19/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Little is known about tobacco smoking behaviors of healthcare professionals in the Middle East where stress conditions are high and tobacco smoking regulations are either absent or loose. The objective of this study was to identify the prevalence of and attitudes toward tobacco smoking among healthcare professionals. METHODS Trained senior medical students conducted a cross-sectional survey study in all governmental and non-governmental hospitals in Nablus city (Palestine) using a self-administered questionnaire containing both open-and closed-ended questions. RESULTS In total, 708 healthcare professionals participated in the study. The mean age of the participants was 31.4 ± 9.6 years. Forty-five (6.4%) participants were ex-smokers, 419 (59.2%) were never smokers, and 244 (34.5%) were current tobacco smokers. One hundred and forty-two (58.2%) tobacco smokers reported that they smoke inside the hospital and 119 (48.8%) reported that they think of quitting smoking. Univariate analysis indicated that age, gender, marital status, family history of tobacco smoking, country of graduation, and night shifts were significantly associated with tobacco smoking status. No significant difference (p = 0.156) in prevalence of tobacco smoking was found between physicians and other healthcare professionals. Binary logistic regression indicated that older age, male gender, and having a positive family history of smoking were significant predictors of being a current tobacco smoker. Non-smokers had significantly higher frequency of patient counseling than current smokers. CONCLUSION Palestinian healthcare professionals have relatively higher prevalence of tobacco smoking compared to the general population. Urgent national intervention and strict implementation of "No Smoking Law" in health institutions and in public places are needed to root out this negative behavior.
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Affiliation(s)
- Isra Y. Mizher
- College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Shahd I. Fawaqa
- College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Waleed M. Sweileh
- Department of Physiology, Pharmacology, and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Chan SSC, Cheung YTD, Wong YMB, Kwong A, Lai V, Lam TH. A Brief Smoking Cessation Advice by Youth Counselors for the Smokers in the Hong Kong Quit to Win Contest 2010: a Cluster Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 19:209-219. [PMID: 28755244 DOI: 10.1007/s11121-017-0823-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Smoking cessation counseling by healthcare professionals is effective, but very few healthcare professionals can deliver these interventions in the busy clinical settings. This study aimed to evaluate the effectiveness of a brief smoking cessation advice delivered by briefly-trained youth counselors at the enrolment of an incentive-based smoking cessation campaign. The study design was a cluster 2-arm randomized controlled trial of 831 Chinese adult smokers who were recruited in public areas to participate in the Hong Kong Quit to Win Contest 2010. The intervention group (n = 441) received a 5-min quitting advice from the youth counselors, who were mainly undergraduate nursing students, and a 12-page self-help smoking cessation booklet at the enrolment, while the control group (n = 390) only received the same booklet. Biochemically confirmed quitters at 6-month follow-up could join a lucky draw that offered HK$10,000 (US$1282) cash prize to three winners and HK$4000 gift vouchers to the other 10 winners. Primary outcome was self-reported smoking abstinence at 6-month follow-up. By intention-to-treat, the intervention group had a non-significantly higher self-reported (18.4 versus 13.8%, OR = 1.40, 95% CI 0.96-2.04, p = 0.08) and validated quit rate (9.1 versus 6.7%, OR = 1.40, 95% CI 0.84-2.33, p = 0.20) than the control group at 6-month follow-up. The analysis with multiple imputation for missing data also found similar results. We concluded that the brief on-site advice by trained youth counselors had a modest effect on smoking cessation, but the effect was not significant. Future studies with larger sample size and results from higher participation of the biochemical validation to confirm the effectiveness are warranted.
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Affiliation(s)
- Sophia Siu Chee Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Yee Tak Derek Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Yee Man Bonny Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Antonio Kwong
- Hong Kong Council on Smoking and Health, Hong Kong, China
| | - Vienna Lai
- Hong Kong Council on Smoking and Health, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Gichuki JW, Opiyo R, Mugyenyi P, Namusisi K. Healthcare Providers' Level of Involvement in Provision of Smoking Cessation Interventions in Public Health Facilities in Kenya. J Public Health Afr 2015; 6:523. [PMID: 28299144 PMCID: PMC5349271 DOI: 10.4081/jphia.2015.523] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 06/21/2015] [Accepted: 07/13/2015] [Indexed: 01/14/2023] Open
Abstract
Healthcare providers can play a major role in tobacco control by providing smoking cessation interventions to smoking patients. The objective of this study was to establish healthcare providers' practices regarding smoking cessation interventions in selected health facilities in Kiambu County, Kenya. This was a descriptive cross-sectional study carried out among healthcare providers working in public health facilities in Kiambu County, Kenya. Self-administered questionnaires were distributed to 400 healthcare providers selected using a two-stage stratified sampling technique. Only 35% of the healthcare providers surveyed reported that they always asked patients about their smoking status. Less than half (44%) reported that they always advised smoking patients to quit. Respondents who had received training on smoking cessation interventions were 3.7 times more likely to have higher practice scores than those without training (OR = 3.66; 95%CI: 1.63-8.26; P = 0.003). Majority of the healthcare providers do not routinely provide smoking cessation interventions to their patients. Measures are needed to increase health worker's involvement in provision of smoking cessation care in Kenya.
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Affiliation(s)
| | - Rose Opiyo
- School of Public Health, University of Nairobi , Kenya
| | - Possy Mugyenyi
- Center for Tobacco control in Africa, School of Public Health, Makerere University , Uganda
| | - Kellen Namusisi
- Center for Tobacco control in Africa, School of Public Health, Makerere University , Uganda
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Smoking-related knowledge, attitude, social pressure, and environmental constraints among new undergraduates in Chongqing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:895-909. [PMID: 25607600 PMCID: PMC4306900 DOI: 10.3390/ijerph120100895] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 12/30/2014] [Accepted: 01/12/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Smoking has resulted in numerous deaths in China. Data indicate that 21% of college students in China are smokers. OBJECTIVE This study aimed to examine the smoking-related behaviors of undergraduates, as influenced by knowledge, attitude, social pressure, and environmental constraints. METHOD A convenience sampling of 412 fresh undergraduates from two universities in the University Town in Chongqing, China was recruited. Chi-square tests were used to compare the smoking-related variables between smokers and non-smokers. Moreover, logistic regression was used to examine the factors that associated with smoking status in undergraduates. RESULTS Smokers and non-smokers differ in terms of knowledge, attitudes toward smoking, participation in tobacco promotional activities, and sources of social pressure. Logistic regression model identified that sex, living cost, five smoking-related attitudes of "Smoking is pleasurable, Smoking relaxes me, Smoking makes me look strong, Smoking is a waste of money, Smoking can help me study better", the social pressure "Smoking brings comfort during celebration", and the environmental constraints "How did you get your cigarettes in the past 30 days?" are significantly associated with smoking. CONCLUSIONS The findings provide a better understanding of the epidemic of smoking among fresh undergraduates in Chongqing, China. This study provides more detailed consideration of the implications for the WHO Framework Convention on Tobacco Control (FCTC) policies, especially on restriction of retail sales outlets and tobacco promotion activities near universities in China.
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Shelley D, Nguyen L, Pham H, VanDevanter N, Nguyen N. Barriers and facilitators to expanding the role of community health workers to include smoking cessation services in Vietnam: a qualitative analysis. BMC Health Serv Res 2014; 14:606. [PMID: 25424494 PMCID: PMC4247125 DOI: 10.1186/s12913-014-0606-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 11/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite high smoking rates, cessation services are largely unavailable in Vietnam. This study explored attitudes and beliefs of community health workers (CHWs) towards expanding their role to include delivering tobacco use treatment (TUT), and potential barriers and facilitators associated with implementing a strategy in which health centers would refer patients to CHWs for cessation services. METHODS We conducted four focus groups with 29 CHWs recruited from four district community health centers (CHCs) in Hanoi, Vietnam. RESULTS Participants supported expanding their role saying that it fit well with their current responsibilities. They further endorsed the feasibility of serving as a referral resource for providers in local CHCs expressing the belief that CHWs were "more suitable than their clinical colleagues" to offer cessation assistance. The most frequently cited barrier to routinely offering cessation services was that despite enacting a National Tobacco Control Action plan, cessation is not one of the national prevention priorities. As a result, CHWs have not been "assigned" to help smokers quit by the Ministry of Health. Additional barriers included lack of training and time constraints. CONCLUSION Focus groups suggest that implementing a systems-level intervention that allows providers to refer smokers to CHWs is a promising model for extending the treatment of tobacco use beyond primary care settings and increasing access to smoking cessation services in Vietnam. There is a need to test the cost-effectiveness of this and other strategies for implementing TUT guidelines to support and inform national tobacco control policies in Vietnam and other low-and middle-income countries.
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Affiliation(s)
- Donna Shelley
- />Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY 10016 USA
| | - Linh Nguyen
- />Institute of Social Medical Studies, Hanoi, Vietnam
| | - Hieu Pham
- />Rush Medical College, Chicago, NY USA
| | - Nancy VanDevanter
- />New York University College of Nursing, Global Institute for Public Health, New York, NY USA
| | - Nam Nguyen
- />Institute of Social Medical Studies, Hanoi, Vietnam
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Sieminska A, Jassem E. The many faces of tobacco use among women. Med Sci Monit 2014; 20:153-62. [PMID: 24487778 PMCID: PMC3915001 DOI: 10.12659/msm.889796] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 10/21/2013] [Indexed: 12/14/2022] Open
Abstract
Smoking is still considered to be mainly a male problem. However, it is estimated that there are approximately 250 million women worldwide who smoke cigarettes and millions more women who use smokeless tobacco products. This article addresses the many facets of tobacco use among women. The aim of the paper is to increase recognition among clinicians and researchers of the specific characteristics of female tobacco use. Together with providing epidemiological data on the distribution of tobacco use among women and data from population-based analyses on sociocultural factors that influence it, the article presents tobacco use during pregnancy as a particularly important public health problem. Further, the article points out sex-related differences (ie, physiological, psychological, or behavioral) between male and female tobacco use. A special focus is on the important role of ovarian hormones. Adverse effects of tobacco use to women and their children as well as tobacco-related morbidities and comorbidities are presented, and women's greater susceptibility to tobacco constituents as compared to men is stressed. Awareness of these differences can contribute to improvement of the effectiveness of smoking cessation programs addressed both to the specific female population and to an individual smoking woman.
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Shelley D, Tseng TY, Pham H, Nguyen L, Keithly S, Stillman F, Nguyen N. Factors influencing tobacco use treatment patterns among Vietnamese health care providers working in community health centers. BMC Public Health 2014; 14:68. [PMID: 24450865 PMCID: PMC3902028 DOI: 10.1186/1471-2458-14-68] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 12/13/2013] [Indexed: 11/19/2022] Open
Abstract
Background Almost half of adult men in Viet Nam are current smokers, a smoking prevalence that is the second highest among South East Asian countries (SEAC). Although Viet Nam has a strong public health delivery system, according to the 2010 Global Adult Tobacco Survey, services to treat tobacco dependence are not readily available to smokers. The purpose of this study was to characterize current tobacco use treatment patterns among Vietnamese health care providers and factors influencing adherence to guideline recommended tobacco use screening and cessation interventions. Methods A cross sectional survey of 134 health care providers including physicians, nurses, midwives, physician assistants and pharmacists working in 23 community health centers in Viet Nam. Results 23% of providers reported screening patients for tobacco use, 33% offered advice to quit and less than 10% offered assistance to half or more of their patients in the past three months. Older age, attitudes, self-efficacy and normative beliefs were associated with screening for tobacco use. Normative beliefs were associated with offering advice to quit. However in the logistic regression analysis only normative beliefs remained significant for both screening and offering advice to quit. Over 90% of providers reported having never received training related to tobacco use treatment. Major barriers to treating tobacco use included lack of training, lack of referral resources and staff to support counseling, and lack of patient interest. Conclusions Despite ratifying the FCTC, Viet Nam has not made progress in implementing policies and systems to ensure that smokers are receiving evidence-based treatment. This study suggests a need to change organizational norms through changes in national policies, training and local system-level changes that facilitate treatment.
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Affiliation(s)
- Donna Shelley
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, USA.
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Abdullah AS, Stillman FA, Yang L, Luo H, Zhang Z, Samet JM. Tobacco use and smoking cessation practices among physicians in developing countries: a literature review (1987-2010). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 11:429-55. [PMID: 24380976 PMCID: PMC3924453 DOI: 10.3390/ijerph110100429] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 12/18/2013] [Accepted: 12/19/2013] [Indexed: 12/02/2022]
Abstract
Physicians have a key role to play in combating tobacco use and reducing the tobacco induced harm to health. However, there is a paucity of information about tobacco-use and cessation among physicians in developing countries. To assess the need for and nature of smoking cessation services among physicians in developing countries, a detailed literature review of studies published in English, between 1987 and 2010 was carried out. The electronic databases Medline and Pub Med were searched for published studies. The findings show that there are regional variations in the current smoking prevalence, quitting intentions, and cessation services among physicians. Smoking prevalence (median) was highest in Central/Eastern Europe (37%), followed by Africa (29%), Central and South America (25%) and Asia (17.5%). There were significant gender differences in smoking prevalence across studies, with higher prevalence among males than females. Smoking at work or in front of patients was commonly practiced by physicians in some countries. Asking about smoking status or advising patients to quit smoking was not common practice among the physicians, especially among smoker physicians. Organized smoking cessation programs for physicians did not exist in all of these regions. This review suggests that while smoking of physicians varies across different developing regions; prevalence rates tend to be higher than among physicians in developed countries. Quitting rates were low among the physicians, and the delivery of advice on quitting smoking was not common across the studies. To promote tobacco control and increase cessation in populations, there is a need to build physicians’ capacity so that they can engage in tobacco use prevention and cessation activities.
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Affiliation(s)
- Abu S Abdullah
- School of Public Health, Guangxi Medical University, Nanning 530021, China.
| | - Frances A Stillman
- School of Public Health, Guangxi Medical University, Nanning 530021, China.
| | - Li Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, China.
| | - Hongye Luo
- School of Public Health, Guangxi Medical University, Nanning 530021, China.
| | - Zhiyong Zhang
- School of Public Health, Guangxi Medical University, Nanning 530021, China.
| | - Jonathan M Samet
- School of Public Health, Guangxi Medical University, Nanning 530021, China.
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Huang C, Guo C, Yu S, Feng Y, Song J, Eriksen M, Redmon P, Koplan J. Smoking behaviours and cessation services among male physicians in China: evidence from a structural equation model. Tob Control 2013; 22 Suppl 2:ii27-33. [PMID: 23821489 PMCID: PMC3756466 DOI: 10.1136/tobaccocontrol-2012-050884] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective To investigate smoking prevalence and cessation services provided by male physicians in hospitals in three Chinese cities. Methods Data were collected from a survey of male physicians employed at 33 hospitals in Changsha, Qingdao and Wuxi City (n=720). Exploratory factor analysis was performed to identify latent variables, and confirmatory structural equation modelling analysis was performed to test the relationships between predictor variables and smoking in male physicians, and their provision of cessation services. Results Of the sampled male physicians, 25.7% were current smokers, and 54.0% provided cessation services by counselling (18.8%), distributing self-help materials (17.1%), and providing traditional remedies or medication (18.2%). Factors that predicted smoking included peer smoking (OR 1.14 95% CI 1.03 to 1.26) and uncommon knowledge (OR 0.94 95% CI 0.89 to 0.99), a variable measuring awareness of the association of smoking with stroke, heart attack, premature ageing and impotence in male adults as well as the role of passive smoking in heart attack. Factors that predicted whether physicians provided smoking cessation services included peer smoking (OR 0.82 95% CI 0.76 to 0.89), physicians’ own smoking (OR 0.87 95% CI 0.81 to 0.93), training in cessation (OR 1.36 95% CI 1.27 to 1.45) and access to smoking cessation resources (OR 1.69 95% CI 1.58 to 1.82). Conclusions The smoke-free policy is not strictly implemented at healthcare facilities, and smoking remains a public health problem among male physicians. A holistic approach, including a stricter implementation of the smoke-free policy, comprehensive education on the hazards of smoking, training in standard smoking-cessation techniques and provision of cessation resources, is needed to curb the smoking epidemic among male physicians and to promote smoking cessation services in China.
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Affiliation(s)
- Cheng Huang
- Department of Global Health, George Washington University, Washington, District of Columbia 20037, USA.
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Wang C, Xiao F, Qiao R, Shen YH. Respiratory medicine in China: progress, challenges, and opportunities. Chest 2013; 143:1766-1773. [PMID: 23732587 PMCID: PMC7094577 DOI: 10.1378/chest.12-1854] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 11/13/2012] [Indexed: 11/02/2022] Open
Abstract
The past century witnessed a rapid development of respiratory medicine in China. The major burden of respiratory disease has shifted from infectious diseases to chronic noninfectious diseases. Great achievements have been made in improving the national standard of clinical management of various respiratory diseases and in smoking control. The specialty of respiratory medicine is expanding into pulmonary and critical care medicine. Nevertheless, respiratory diseases remain a major public health problem, with new challenges such as air pollution and nosocomial infections. This review describes the history, accomplishments, new challenges, and opportunities in respiratory medicine in China.
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Affiliation(s)
- Chen Wang
- Beijing Hospital, Beijing Institute of Geriatrics, Key Laboratory of Geriatrics, Ministry of Health, Beijing, China; Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Department of Respiratory Medicine, Capital Medical University, Beijing, China.
| | - Fei Xiao
- Beijing Hospital, Beijing Institute of Geriatrics, Key Laboratory of Geriatrics, Ministry of Health, Beijing, China
| | - Renli Qiao
- Department of Pulmonary and Critical Care Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Smith DR, Zhao I, Wang L. Tobacco smoking among doctors in mainland China: a study from Shandong province and review of the literature. Tob Induc Dis 2012; 10:14. [PMID: 23006640 PMCID: PMC3519549 DOI: 10.1186/1617-9625-10-14] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 09/14/2012] [Indexed: 11/29/2022] Open
Abstract
UNLABELLED BACKGROUND Tobacco control represents a key area in which doctors can make a significant positive impact on their patients' lives. Despite this fact, however, doctors in certain regions of China are known to smoke tobacco at rates similar to or even exceeding those seen within the general population. OBJECTIVE This study sought to investigate the smoking habits of doctors at a teaching hospital in Shandong province, as well as providing a brief review of smoking research that has been conducted among doctors elsewhere in China. METHOD An anonymous questionnaire survey was distributed to doctors working at a university teaching hospital in 2008, as part of a larger study of occupational health issues in the healthcare profession. RESULTS The overall smoking prevalence rate of doctors in this study was 36.3% with significant differences observed between the genders (males: 46.7% and females: 5.3%). Age and total career length were also correlated with smoking habit, although no significant associations were found with department of employment. CONCLUSIONS Overall, our study suggests that smoking rates among doctors in Shandong province are higher than those documented in many other countries, a finding which is consistent with previous research conducted in some other Chinese provinces. Addressing this issue from an intrinsic cultural perspective will clearly need to form the cornerstone of tobacco control efforts within the Chinese medical community in future years.
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Affiliation(s)
- Derek R Smith
- School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, New South Wales, Australia
| | - Isabella Zhao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lina Wang
- Department of Medicine, Longkou Chinese Medicine Hospital, Longkou, Shandong, China
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