Smoking behaviours and cessation services among male physicians in China: evidence from a structural equation model

Abstract

ObjectiveTo investigate smoking prevalence and cessation services provided by male physicians in hospitals in three Chinese cities.MethodsData were collected from a survey of male physicians employed at 33 hospitals in Changsha, Qingdao and Wuxi City (n=720). Exploratory factor analysis was performed to identify latent variables, and confirmatory structural equation modelling analysis was performed to test the relationships between predictor variables and smoking in male physicians, and their provision of cessation services.ResultsOf the sampled male physicians, 25.7% were current smokers, and 54.0% provided cessation services by counselling (18.8%), distributing self-help materials (17.1%), and providing traditional remedies or medication (18.2%). Factors that predicted smoking included peer smoking (OR 1.14 95% CI 1.03 to 1.26) and uncommon knowledge (OR 0.94 95% CI 0.89 to 0.99), a variable measuring awareness of the association of smoking with stroke, heart attack, premature ageing and impotence in male adults as well as the role of passive smoking in heart attack. Factors that predicted whether physicians provided smoking cessation services included peer smoking (OR 0.82 95% CI 0.76 to 0.89), physicians’ own smoking (OR 0.87 95% CI 0.81 to 0.93), training in cessation (OR 1.36 95% CI 1.27 to 1.45) and access to smoking cessation resources (OR 1.69 95% CI 1.58 to 1.82).ConclusionsThe smoke-free policy is not strictly implemented at healthcare facilities, and smoking remains a public health problem among male physicians. A holistic approach, including a stricter implementation of the smoke-free policy, comprehensive education on the hazards of smoking, training in standard smoking-cessation techniques and provision of cessation resources, is needed to curb the smoking epidemic among male physicians and to promote smoking cessation services in China.

Addicted Health Care Professionals: Missing the Wood for the Trees?

“…In fact, it is a major barrier to tobacco interventions with patients. When compared with physicians who smoke, nonsmoking physicians are more likely to identify the smoking status of their patients, provide advice on quitting and intensive cessation counseling, and initiate cessation interventions (Huang et al 2013). Last, the role model cannot be ignored.…”

The global tobacco control ‘endgame’: Change the policy environment to implement the FCTC

“…[33][34][35] Scientific research capacity is low. 36 India has demonstrated a commitment to the FCTC and is a world leader in the regulation of tobacco use in media and films.…”

Use of Smoking Cessation Interventions by Physicians in Argentina

“…Physician smoking status was a negative predictor of cessation success in several studies (Huang et al, 2013; Juliao et al, 2013; Ng et al, 2007; Noble, Perez Stable, & Casal, 1996; Pipe et al, 2009; Ulbricht et al, 2009), but it showed no effect on others (Gigliotti et al, 2013; Sadowski et al, 2009). Physician gender has also shown conflicting results (Frank & Harvey, 1996;Soto Mas et al, 2005; Soto Mas et al, 2008; Zhou et al, 2010).…”

“…Moreover, brief physician-implemented counselling interventions can increase the absolute rate of cessation by 1% to 3% (Alba, Murillo, & Castillo, 2013; Stead et al, 2013). However, despite the efforts to promote physician-led interventions for smoking cessation, few clinicians consistently implement them (Huang et al, 2013; Kruger et al, 2012; Lee et al, 2007; Pipe, Sorensen, & Reid, 2009) particularly in Latin American countries (Gigliotti et al, 2013; Juliao et al, 2013; Mejia et al, 2010). Physicians have also reported lack of training to help their patients quit and limited time for counselling during clinic visits (Perez-Stable et al, 2001; Soto Mas et al, 2005; Vogt, Hall, & Marteau, 2005; Warren, Jones, & Chauvin, 2008).…”

“…The main predictors of physician-implemented smoking cessation interventions were specific training (Huang et al, 2013; Sadowski, Ruffieux, & Cornuz, 2009; Soto Mas et al, 2008) (Schnoll, Rukstalis, Wileyto, & Shields, 2006; Twardella & Brenner, 2005; Zhou et al, 2010), clinician self-efficacy (Sadowski et al, 2009; Soto Mas et al, 2008) (Schnoll et al, 2006), and younger physician age (Schnoll et al, 2006). Physician smoking status was a negative predictor of cessation success in several studies (Huang et al, 2013; Juliao et al, 2013; Ng et al, 2007; Noble, Perez Stable, & Casal, 1996; Pipe et al, 2009; Ulbricht et al, 2009), but it showed no effect on others (Gigliotti et al, 2013; Sadowski et al, 2009).…”