The Effect of Public Health Measures during the COVID-19 Pandemic on Smoking Dependence & Passive Smoking

Background: According to increasing concern about the COVID-19 pandemic and the risk of smoking this study was conducted to find the effect of health measures during the COVID-19 pandemic on smoking dependence & passive smoking. Methods: A cross-sectional study was conducted in September 2020, by using a valid and reliable questionnaire, the data were analyzed by using SPSS, version 20 software. Results: The study showed 16.9% of participants increased their nicotine use and 12.4% decreased their nicotine use. Despite no significant change in smoking dependence, we found that smokers who used to smoke more than 30 cigarettes per day before the quarantine increased by two folds. In addition, we found that smokers who awaken at night sometimes to have cigarettes before quarantine had increased markedly by 50% during quarantine. Furthermore, smokers who had an extreme urge to smoke over the week before the quarantine have elevated markedly during the quarantine from 31 smokers to 60. Also, over 35.2 % of surveyed individuals experienced a rise in smoking desire during the quarantine. Regarding passive smoking, the surveyed individuals reported a generally slight decline in exposure to secondhand smoking. However, the number of exposed individuals to smoking for more than 8 hours increased by 27%. Conclusion: During the lockdown, individuals smoked marginally more cigarettes compared to the periods before the lockdown with no significant change in smoking dependence. There was a slight decline in exposure to secondhand smoking. However, the number of exposed individuals to household smoking for more than 8 hours had been increased.

Impact on core values of family medicine from a 2-year Master's programme in Gezira, Sudan: observational study

BACKGROUND

Training of family physicians should include not only clinical and procedural skills, but also core values as comprehensive care, continuity of care, leadership and patient-centeredness. The Gezira Family Medicine Project (GFMP) is a 2 years Master's programme in family medicine in Sudan. We assessed the impact of GFMP on the candidates' adherence to some core values of family medicine.

METHODS

This is a prospective study with before-after design based on repeated surveys. We used Patient-Practitioner Orientation Scale (PPOS) to assess physicians' attitude towards patient-centeredness. Practice based data from individual patients' consultations and self-assessment methods were used to assess physicians' adherence to core values.

RESULTS

At the end of the programme the candidates (N = 110) were significantly more active in community health promotion (p <  0.001), more confident as a team leader (p = 0.008), and showed increased adherence to national guidelines for managing diabetes (p = 0.017) and hypertension (p = 0.003). The responding candidates had more knowledge about patients' medical history (p <  0.001), family history (p < 0.001) and family situation (p < 0.001). There were more planned follow up consultations (p < 0.001) and more referrals (p = 0.040). In contrast, results from PPOS showed slightly less orientation towards patient-centeredness (p = 0.007).

CONCLUSIONS

The GFMP Master's programme induced a positive change in adherence to several core values of family medicine. The candidates became less patient-centered.