RESEARCH – May 2016

Smoking habits, smoking related opinions and attitudes towards patients` smoking habits among physicians in Estonia

Authors: Liis Lohur, Kersti Pärna

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Background. Physicians play an important role in influencing their patients’ health behaviour. The personal smoking habits of physicians might have an effect on their views towards smoking cessation activities and their willingness to discuss smoking with patients.

Objectives. This study examined the smoking habits of Estonian physicians, and their smoking related opinions and attitudes toward the smoking habits of their patients with regard to their own smoking status.

Study design and methods. A cross-sectional postal study, based on a self-administered questionnaire, was carried out among all practising physicians in Estonia in 2014. Acting physicians under 65 years of age (n = 2334) were studied.

Results. The current smoking prevalence was 16.2% for male and 6.4% for female physicians (12.5% and 4.9%, respectively, were daily smokers). Of the men, 61.2% and of the women 48.1% agreed that their current knowledge and skills were sufficient to instruct their patients on giving up smoking, with significant differences between the men and the women (p = 0.002). The majority of the physicians considered smoking prevention to be necessary in basic training, while women were more willing to agree with the statement (p = 0.012). There were no significant differences between the male and female physicians in inquiring about their patients’ smoking status during the past week, although nearly one tenth of them had not done so. Non-smoking physicians were more likely to ask about their patients’ smoking habits than those who smoked (men OR = 2.57; 95% CI 1.13–5.87; women OR = 2.02; 95% CI 1.12–3.64). The main reasons for not inquiring about patients` smoking habits were lack of time, the belief that they could not influence patients’ smoking practices and lack of habit in their examination routine. Compared to the smoking female physicians, the nonsmoking female physicians were less likely to consider the issue insignificant (OR = 0.36; 95% CI 0.19–0.70), were less likely to believe that it was someone else’s job (OR = 0.44; 95% CI 0.26–0.73), or did not wish to disturb patients’ privacy (OR = 0.55; 95% CI 0.33–0.93). The non-smoking male physicians were less likely than their smoking male colleagues to consider the wish not to disturb patients’ privacy as a reason for not paying attention to their smoking habits (OR = 0.42; 95% CI 0.20–0.90).

Conclusions. The results provide a useful overview of Estonian physicians’ smoking habits, smoking related opinions and the factors that limit their ability to contribute to smoking cessation activities. It is an important challenge for medical education in Estonia to provide physicians with the knowledge and practical skills that are necessary to help their patients quit smoking.