Effect of medical education on smoking behaviour

Abstract

SUMMARYAt Manchester University medical students (n = 658) had more knowledge than law students (n = 245) about the hazards of smoking, were more convinced by the relevant evidence, and assessed the risk to health more highly. However, there was no significant difference in their smoking behaviour. Among medical students 61% were non-smokers, 10% ex-smokers, and 29% smokers, of whom three-fifths smoked regularly. During their training they were more likely to start smoking than to give it up, and more likely to increase their consumption than decrease it. Expansion of smoking occurred especially in the early years of the course, whereas the main increase in knowledge was in the clinical period. Students' knowledge and their opinion of the evidence were related to their stage of education, whereas their assessment of the risk was linked with their smoking behaviour. Expansion of smoking at medical school may be forestalled by providing information about the hazards as early as possible, although some smokers will continue the habit irrespective of knowledge.

Teaching medical students about tobacco

“…22 A comparison of rates across countries reveals that medical education fails to bring about a decrease in smoking rates. Students seem more likely to begin smoking in medical school than to give it up, and to increase their cigarette consumption rather than decrease it, 58 supporting the suggestion that, in medical students, medical education and knowledge about the harmful eVects of smoking have relatively little impact on smoking. 22 Reviewing the students' smoking rates in table 1, this comment appears to describe a worldwide phenomenon-that the eVect of increased knowledge about smoking does not relate to students' smoking behaviour.…”

“…Although students accept that not smoking is part of the doctor's exemplar role, the modelling of non-smoking has not been presented consistently to them as some members of the teaching staV were smokers and may have justified their habit to students. 58 The ambivalent picture presented by staV to students may encourage continued smoking among students. A more determined and concerted eVort is required in which quit programmes are oVered to students, and teaching staV present as non-smoking models.…”

“…While many medical schools teach about tobacco, providing the necessary information upon which to make an informed decision about continued tobacco use, for many students the timing of the information may be too late if given in the clinical years as initiation of smoking occurs earlier in the medical course, in the pre-clinical years, 58 or even before medical school. 74 This evidence highlights the need for the topic of tobacco to be introduced early in the medical course and continued throughout the years of study.…”

Prevalencia de tabaquismo y actitud de cambio frente al hábito tabáquico en universitarios chilenos: Importancia de la formación médica

“…Lo anterior pone de manifiesto que la Facultad de Medicina no estaría ejerciendo una influencia positiva en disminuir la prevalencia del tabaquismo, sino más bien estaría determinando que los estudiantes de Medicina de cursos avanzados fumen más que aquellos de cursos iniciales. Estos hallazgos resultan compatibles con lo descrito en la literatura internacional [8][9][10][11] . Para entender el porqué de estos hallazgos, se necesitarán nuevos estudios que permitan conocer las posibles causas (ejemplo: presencia de docentes fumadores, de un ambiente permisivo, etc.…”

“…De manera sorprendente, este aumento de conocimiento no se asocia a menores tasas de tabaquismo, ya que los estudiantes de Medicina de cursos avanzados generalmente fuman más que aquellos de cursos iniciales [8][9][10][11] . El objetivo del presente estudio es determinar la prevalencia de tabaquismo y la actitud de cambio frente al hábito tabáquico en estudiantes de Medicina e Ingeniería, de primer y cuarto año de la Universidad de Chile.…”