Concurrent Situation Of Preparations For Implementing FCTC By Heath Workers In Pudong New District, Shanghai

Tobacco use,a preventable while most dangerous factor that endangers humans' health,is the most serious public health problems in the world.In order to globalize tobacco control,WHO adopted a resolution at the 49^th conference in May,1996,which authorized WHO to start Framework Convention on Tobacco Control(FCTC).This is the first multilateral treaty by WHO intending to solve a public health issue,indicating WHO's resolution to restrict tobacco use throughout the world.China,one of the signatory powers to the treaty,takes a positive stand on smoking control.As the 12^th item of the treaty states,"...enhance the consciousness of both public and private organizations(primary health centers in particular) to take an active part in the establishment and practice of cooperative smoking control projects and smoking control strategies",the treaty sets a considerable demand on medical workers,especially community health workers.Therefore, for the medical workers at community health centers there is no shirking the responsibility to practice and advocate the treaty.Based on some other literature and experts' opinions as well,the present study referred to and adapted the questionnaire of GHPS(Global Health Professional Survey) to design the research questionnaire.The current situation of the smokers among the medical workers at community health centers in Pudong New District,Shanghai,their knowledge and opinions about the treaty as well as community health centers' preparations for implementing smoking control are all analyzed in the present thesis for the purpose of providing the government and community health workers with policy suggestions to practise the treaty in real earnest.The results are as follows:1.The current situation of the smokers among the medical workers at community health centers in Pudong New District,ShanghaiThe smokers account for 17.8%of the medical workers at community health centers in Pudong New District,Shanghai,among them 56.2%for male and 1.7%for female.The smoking rate is higher than expected,which would certainly impair the effect of tobacco control throughout the society,so tobacco control among community medical workers is imperative under the situation. To make it worse,the harm of passive smoking is always neglected.2.Community medical workers' knowledge and opinions about FCTC45.3%of them knew nothing about China's approval of FCTC in 2005,and only 58.1%of them claimed to have heard of the treaty.While 88.3% supported the treaty completely,2.5%of the administrators were absolutely against it,being the toughest obstacle to the practice of the treaty.The comprehensive analysis here shows that the current smokers and those who don't know the treaty lend less support to FCTC.3.Community health centers' preparations for implementing smoking control3.1 No- smoking rules and the practice of them8.9%of the medical workers claimed that no-smoking rules had never been carried out where they work.3.5%of them stated that smoking is not forbidden at all in their hospitals.The present survey showed that 12.6%of the community medical workers have smoked while at work in the past year.3.2.Tobacco-control education and training55.1%of the community health workers claimed that they haven't,whether at college or after graduation,taken any course related to the harm of tobacco. 79.8%of the staff claimed that they had never received any professional training to help patients quit smoking.Only 58.4%claimed that they knew that "it is helpful to provide support and intervention materials such as kinescopes and leaflets for the patients who are willing to quit smoking".And only 33.6% claimed to have heard of speedy intervention.3.3 Methods for smoking cessation and projects on tobacco control in community health centersIn routine clinical work,only 18.0%of the medical workers have applied substitute products of nicotine to the smokers intending to quit smoking;20.9% have applied speedy intervention;12.3%have applied traditional Chinese medicine;47.1%have provided intervention materials for the patients;and 21.9%have conducted tobacco-control projects in communities,such as smoking cessation courses and non-smoking family contests.The comprehensive analysis here shows that smoking cessation intervention wins more favor of the medical institutions that practice tobacco control policies and the health workers who have received the relevant courses and training.And also,smoking cessation intervention enjoys more popularity among general practitioner,nurses and health workers of disease prevention than other logistic workers.3.4.Proposals of implementing FCTC in China by the health workers in community centers.According to the health workers in community centers,the following factors stand in the way of implementing FCTC in China:the lack of supporting policies,the uncertainty of the executor,the inadequacy of the publicity,the poor knowledge of the mass,the pursuit of developing tobacco economy,the negative influence of the tradition and culture,and the smokers' lack of consciousness of tobacco control.To promote the implementation of the treaty,their proposals for the government from the perspective of macro-policy are as follows:to strengthen governmental legislation,to lay down developmental strategy for tobacco industry,to enhance publicity and education,to establish grades of tobacco-control network and administration,and to advance both the quality and health consciousness of the whole people.From the perspective of community administration,the great majority of the health workers believes that the medical staff should set a good example of non-smokers to the patients,and meanwhile conduct an active campaign of smoking cessation and tobacco-control publicity.In terms of tobacco- control publicity,most of the medical workers propose that various media be taken full advantage of,including TV,radio,newspapers,magazines,internet, information boards,to increase the publicity of the commonweal advertisements.In terms of education and training,it is suggested that both the professional training and the youth's tobacco-control education should be strengthened.Conclusions and suggestionsThe conclusions drawn from the present survey are as follows:There is a comparatively high smoking rate in community health centers, especially among the male workers,so serious passive smoking exists in these centers.Tobacco- control policies have not been strictly established and put into practice in these centers.A comparatively high rate of the medical workers support FCTC,but they know little about it.As a whole,the medical workers keep an active attitude towards tobacco control,but they are in great need of tobacco-control training and education.Also,they lack effective methods of smoking cessation,and their efforts to conduct tobacco-intervention and tobacco-control projects in communities haven't resulted in satisfaction.And the suggestions are as follows:First of all,as the model of health,the health workers in community centers ought to develop a proper attitude toward tobacco control,strengthen publicity of FCTC among them,and enhance the intervention in health workers' tobacco use so as to decrease the proportion of smokers.Secondly,as the guide of health,they are supposed to receive further tobacco-control training.And the health workers who offer smoking cessation service should be supported by policies.Thirdly,as the advocator of health,the health workers should be encouraged to conduct campaigns in communities to urge the residents to control tobacco use.Finally,the medical staff and the patients should be protected from the harm of passive smoking.It is suggested to set up and perfect hospital-based no-smoking policies because the centers also deliver service for children.According to the treaty,hospital-based non-smoking policies should enjoy priority in terms of legislation so as to solve the problem of passive smoking.