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      Tobacco Use and Smoking Cessation Practices among Physicians in Developing Countries: A Literature Review (1987–2010)


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          Physicians have a key role to play in combating tobacco use and reducing the tobacco induced harm to health. However, there is a paucity of information about tobacco-use and cessation among physicians in developing countries. To assess the need for and nature of smoking cessation services among physicians in developing countries, a detailed literature review of studies published in English, between 1987 and 2010 was carried out. The electronic databases Medline and Pub Med were searched for published studies . The findings show that there are regional variations in the current smoking prevalence, quitting intentions, and cessation services among physicians. Smoking prevalence (median) was highest in Central/Eastern Europe (37%), followed by Africa (29%), Central and South America (25%) and Asia (17.5%). There were significant gender differences in smoking prevalence across studies, with higher prevalence among males than females. Smoking at work or in front of patients was commonly practiced by physicians in some countries. Asking about smoking status or advising patients to quit smoking was not common practice among the physicians, especially among smoker physicians. Organized smoking cessation programs for physicians did not exist in all of these regions. This review suggests that while smoking of physicians varies across different developing regions; prevalence rates tend to be higher than among physicians in developed countries. Quitting rates were low among the physicians, and the delivery of advice on quitting smoking was not common across the studies. To promote tobacco control and increase cessation in populations, there is a need to build physicians’ capacity so that they can engage in tobacco use prevention and cessation activities.

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          Most cited references79

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          Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library.

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            Chinese physicians and their smoking knowledge, attitudes, and practices.

            China has the most smokers among the world's nations. Physicians play a key role in smoking cessation, but little is known about Chinese physicians and smoking. This 2004 clustered randomized survey of 3552 hospital-based physicians from six Chinese cities measured smoking attitudes, knowledge, personal behavior, and cessation practices for patients. Descriptive statistics and multivariate analysis of factors associated with asking about or advising against smoking were conducted in 2005 and 2006. Smoking prevalence was 23% among all Chinese physicians, 41% for men and 1% for women. Only 30% report good implementation of smoke-free workplace policies and 37% of current smokers have smoked in front of their patients. Although 64% usually advise smokers to quit, only 48% usually ask about smoking status, and 29% believe most smokers will follow their cessation advice. Less than 7% set quit dates or use pharmacotherapy when helping smokers quit. Although 95% and 89%, respectively, know that active or passive smoking causes lung cancer, only 66% and 53%, respectively, know that active or passive smoking causes heart disease. Physicians were significantly more likely to ask about or advise against smoking if they believed that counseling about health harms helps smokers quit and that most smokers would follow smoking-cessation advice. Physician smoking cessation, smoke-free workplaces, and education on smoking-cessation techniques need to be increased among Chinese physicians. Strengthening counseling skills may result in more Chinese physicians helping smoking patients to quit. These improvements can help reduce the Chinese and worldwide health burden from smoking.
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              The World Bank


                Author and article information

                Int J Environ Res Public Health
                Int J Environ Res Public Health
                International Journal of Environmental Research and Public Health
                30 December 2013
                January 2014
                : 11
                : 1
                : 429-455
                [1 ]School of Public Health, Guangxi Medical University, Nanning 530021, China; E-Mails: yangli8290@ 123456hotmail.com (L.Y.); Hongye283@ 123456163.com (H.L.); rpazz@ 123456163.com (Z.Z.);
                [2 ]Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA 02218, USA
                [3 ]Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; E-Mail: fstillma@ 123456jhsph.edu
                [4 ]Department of Preventive Medicine, Keck School of Medicine of USC, USC Institute for Global Health, University of Southern California, Los Angeles, CA 90033, USA; E-Mail: jsamet@ 123456med.usc.edu
                Author notes
                [* ] Author to whom correspondence should be addressed; E-Mail: asm.abdullah@ 123456graduate.hku.hk ; Tel.: +1-617-638-7547; Fax: +1-617-638-8858.
                © 2013 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open ccess article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                : 11 November 2013
                : 18 December 2013
                : 19 December 2013

                Public health
                review literature,developing countries,smoking cessation,tobacco use,physicians
                Public health
                review literature, developing countries, smoking cessation, tobacco use, physicians


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