Doctors Tobacco Hazards In China-related Knowledge, Attitude And Its Smoking Cessation Service Capacity Study

ObjectivesThe aims of the study are: 1) to understand Chinese physicians' knowledge and attitudes related to tobacco harms and their abilities to provide smoking cessation services; 2) to examine factors associated with physicians' intentions to quit smoking; 3) to provide scientific basis for providing better smoking cessation services to physicians, decreasing smoking rate among physicians, improving their capabilities of providing smoking cessation services, and developing policies related to smoking cessation among physicians.MethodsThe study was a cross-sectional survey conducted in all the 31 provinces (autonomous region, municipality) and Xinjiang Production and Construction Corps form Apr 2008 to Aug 2008. Within each province, 3 sites of different levels (province, city, and county) were selected as our project fields. Simple random sampling was used to sample health facilities, and then physicians were also chosen as our subjects by simple random sampling. Qualitative interview and quantitative investigation were applied to collect related data. SPSS13.0 software was used in statistics analysis. The mainly analytic methods included: Descriptive analysis, x~2 Test, Nonparametric test and Logistic regression.Results977 hospitals of different levels were investigated in all 96 fields during the study. A total number of 39731 questionnaires were collected, among which 39248 questionnaires were effective (effective rate 98.8%).1. Smoking and quitting among physiciansAmong the physicians, the overall smoking rate was 25.0%, and the current smoking rate was 20.4%. Among the smoking physicians. 30.4% reported smoking in front of patients sometimes or frequently, and 76.4% reported smoking on duty sometimes or frequently. The physicians' rate of quitting smoking was 12.7%, and 43.4% of the smoking physicians reported that they had tried to quit smoking seriously.2. Physicians' knowledge about and attitudes towards tobacco harmsMore than 95% of the physicians knew that "smoking causes lung cancer and coronary heart disease": however, 86.8% believed that "the nicotine in cigarettes is the chemical that causes most of the cancer", and 14.1% disagreed with the statement that physicians should set a non-smoking example.3. Physicians' intentions to quit smokingAmong the smoking physicians, 43.2% had plans to quit smoking, and the main reasons were: concern for personal health (94.1%), concern of the effects of tobacco smoke on other family members (81.1%), physicians' profile (63.3%), and rules of institutions (46.9%). The result of Logistic regression shows that factors associated with intentions to quit on willingness include: the level of hospital, age, smoking age, times of trying to quit smoking and the knowledge related to tobacco harms.4. Physicians' capabilities to provide smoking cessation servicesAmong the physicians, 17.4% reported that they rarely to ask patients about the smoking conditions, only 2.4% provided smoking cessation medication to patients, and 25.8% disagreed with the statement that physicians should actively provide smoking cessation services to patients. The result of Logistic regression shows that factors associated with actively providing smoking cessation advices include: city, the level of hospital, department, gender, education, smoking conditions and the knowledge about tobacco harms.Conclusions1. The strengths of enforcing to quit smoking among physicians are weak and the smoking rate decreases slowly.2. The health education to physicians about the harms related to tobacco has many shortcomings.3. The effectiveness of smoking cessation among physicians is not so well and there are many obstacles to actualizing smoking cessation.4. The physicians' consciousness of controlling smoking are absent and the capabilities of providing smoking cessation services need to be improved.