HEALTH: Teach What You Preach, WHO Tells Doctors on No Tobacco Day

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, May 30 2005 (IPS) - The first battle in the war on tobacco needs to be fought among health care professionals, who are a trusted source of information and advice or their patients and are therefore uniquely qualified to encourage others to kick this deadly habit.

Yet the high number of health care professionals who smoke can hinder efforts in this regard, which is why the World Health Organisation (WHO) has dedicated this year’s World No Tobacco Day, on May 31, to the important role that health professionals play in tobacco control, under the banner of “Health Professionals Against Tobacco, Action and Answers”.

Studies cited by WHO reveal that even brief advice from medical professionals can increase tobacco abstinence rates by up to 30 percent, while nurse-led initiatives to quit smoking have up to a 50 percent greater chance of success.

Yet it is difficult for health professionals to encourage their patients to kick the smoking habit when they themselves are addicted.

Studies of tobacco consumption among health professionals – such as doctors, dentists, pharmacists, nurses and midwives – reveal highly diverse patterns in different parts of the world.

In countries like Canada and Finland, less than 10 percent of members of this sector are smokers. In Russia, however, 63 percent of male doctors smoke, an even higher proportion than the 61 percent rate for the male population as a whole. In the meantime, 13 percent of women doctors smoke, as compared to 9.7 percent of the Russian female population overall.

In China, 61.3 percent of male doctors are smokers, only slightly below the overall male average of 66.9 percent. And while only 4.2 percent of Chinese women in general are smokers, the smoking rate among women doctors is 12.2 percent.

Russia is not a signatory of the WHO Framework Convention on Tobacco Control (FCTC), while China has signed the agreement but has yet to ratify it, noted Vera Luiza Costa e Silva, director of WHO’s Tobacco Free Initiative.

“Countries that have less stringent tobacco control activities or regulations have a higher prevalence of tobacco use among health professionals,” she explained.

Spain is another country with a high proportion of doctors who smoke, as well as higher smoking rates among female nurses than in the female population as a whole.

Health professionals serve as role models for their patients, which makes it difficult for them to be consistent when advising others to give up tobacco. “There are some studies showing that health professionals who smoke are not very active in promoting smoking cessation among their patients,” reported Costa e Silva.

The Framework Convention, which entered into force on Feb. 27 and has been ratified by 65 nations so far, emphasises the role of health professional associations in efforts to include tobacco control on the public health agenda and to contribute actively to the reduction of tobacco consumption.

“Health professionals are very important from the point of view of tobacco control, because they are role models in their societies. They are health care providers and they can support smokers in their efforts to quit, because they are sources of information and are educators for the population,” she stressed.

Health professionals are also leaders in the community, with associations representing the different related professions in most countries around the world.

“They watch the tobacco industry, and can publicly call on governments and universities to refuse to invest their funds in tobacco industry stocks,” added the WHO representative.

The tobacco industry has tried for many years to use scientists and especially health professionals from the developing countries, and from the developed nations also, to conduct research with a biased perspective, misleading the public about the health effects of tobacco smoke, said Costa e Silva.

“Apart from this, they have also been very active in sponsoring universities and even medical schools. They have recently begun providing students with scholarships as well for different universities. So they have been very successful in bringing in these players and using them as part of their market strategies worldwide,” she said.

This practice of targeting groups who can be instrumental in marketing and are relevant from the point of view of tobacco control is nothing new, she added, noting that doctors were used as part of tobacco ads in the 1940s.

“Tobacco continues to be a leading global killer, with nearly five million deaths a year,” stressed WHO Director-General Lee Jong-wook. “The health community plays a key role in the global effort to fight this epidemic. Health professionals are on the frontline. They need the skills to help people stop smoking, and they need to lead by example, and quit tobacco use themselves.”

Nevertheless, recent surveys conducted in 10 countries among third-year students in four health-profession disciplines – dentistry, medicine, nursing, and pharmacy – indicated that only five to 36.6 percent of these students had received formal training in how to counsel patients to quit smoking.

The highest figure, 36.6 percent, pertains to pharmacy students in the Philippines, while the low of 5.2 percent was found among students at four medical schools in Buenos Aires, the capital of Argentina.

The study results also revealed that cigarette smoking among the students was higher than 20 percent in seven of the 10 countries surveyed.

Costa e Silva mentioned another recent survey, conducted by the U.S. Centres for Disease Control and Prevention (CDC), which points to a decrease in the number of smokers in the United States.

In 2003, approximately 21.6 percent of adults in the United States, or over 45 million people, were smokers, as compared to 22.5 percent in 2002 and 22.8 percent in 2001, the study noted.