186008 Can smoke-free physicians lead the way to a tobacco-free China?

Monday, October 27, 2008

Xiaodong Kuang , Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, WI
Marion Ceraso, MHS , Population Health Institute, University of Wisconsin, Madison, WI
Jane A. McElroy, PhD , Department of Family and Community Medicine, University of Missouri, Columbia, MO
Peter Vila , Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI
Xueping Du , Beijing Fuxing Hospital, Beijing, China
Long Lv , Inner Mongolia Hospital, Hohhot, China
Hongkun Ren , Inner Mongolia Hospital, Hohhot, China
Ning Qian , Beijing Fuxing Hospital, Beijing, China
Jianqin Dong , Beijing Fuxing Hospital, Beijing, China
Douglas Jorenby , School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Michael Fiore, MD, MPH, MBA , Center for Tobacco Research and Intervention, University of Wisconsin Medical School, Madison, WI
Background: Some western countries have witnessed an overall decrease in tobacco use after the elimination of smoking among physicians. Helping physicians quit might serve as a starting point to turn the tide on the high rates of tobacco use in China.

Methods: To better understand Chinese physicians' smoking-related knowledge, attitudes and practices, we conducted a baseline survey in a convenience sample of 416 healthcare providers in two Chinese research hospitals and four focus groups in the same two hospitals.

Result: Smoking rates remain high among male physicians (50%) and are linked to decreased awareness of smoking-related risks and a lower likelihood to believe that physicians should advise patients to quit. Both smoking and non-smoking physicians reported accepting cigarettes as gifts, and those who did were less likely to ask their patients to quit. Physicians reported receiving little or no support for their own cessation efforts and limited training on how to intervene with their patients who smoke. Focus group data supported these findings. Physicians furthermore described an environment in which smoking is socially acceptable even for health professionals and serves as an important relationship builder. Our data provided some clues for the development of effective intervention strategies.

Conclusion: A culturally appropriate intervention strategy that addresses the social function of smoking is urgently needed to help Chinese physicians quit. Enforcement of smoke-free policies in hospitals, training on appropriate patient practices, and utilization of social support mechanisms should also be part of the intervention strategy.

Learning Objectives:
Describe tobacco use and tobacco-related knowledge, attitudes, behaviors and patient practices among Chinese male physicians. Learn about the barriers to quitting, perceived effectiveness of various quit methods, and relevance of social support in quitting among Chinese male physicians. Consider some potential components of a culturally appropriate tobacco dependence treatment strategy for Chinese male physicians.

Keywords: Tobacco Control, International Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in this project from the beginning, and I was part of the project leadership.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.