Tobacco-related medical education and physician interventions with parents who smoke: Survey of Canadian family physicians and pediatricians

Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5.
Canadian family physician Medecin de famille canadien (Impact Factor: 1.34). 02/2010; 56(2):157-63.
Source: PubMed


To examine the relationship between physicians' tobacco-related medical training and physicians' confidence in their tobacco-related skills and smoking-related interventions with parents of child patients.
Mailed survey.
The survey was mailed to 800 family physicians and 800 pediatricians across Canada, with a corrected response rate of 65% (N = 900).
Physicians' self-reported tobacco-related education, knowledge, and skills, as well as smoking-related interventions with parents of child patients. Cochran-Mantel-Haenszel chi(2) tests were used to examine relationships between variables, controlling for tobacco-control involvement and physician specialty. Data analysis was conducted in 2008.
Physicians reporting tobacco-related medical education were more likely to report being "very confident" in advising parents about the effects of smoking and the use of a variety of cessation strategies (P < .05). Furthermore, physicians with tobacco-related training were more likely to help parents of child patients quit smoking whether or not the children had respiratory problems (P < .05). Physicians with continuing medical education in this area were more likely to report confidence in their tobacco-related skills and to practise more smoking-related interventions than physicians with other forms of training.
There is a strong relationship between medical education and physicians' confidence and practices in protecting children from secondhand smoke. Physicians with continuing medical education training are more confident in their tobacco-related skills and are more likely to practise smoking-related interventions than physicians with other tobacco-related training.

Download full-text


Available from: Roberta Ferrence
  • Source
    • "Formal training in tobacco dependence counseling leads to higher self-efficacy and more frequent counseling among physicians.(Leone et al., 2009; Ockene et al., 1988; Victor et al., 2010). Development of tobacco dependence counseling competencies is a recommended component of medical education in order to help trainees develop the knowledge and skills needed to help patients quit smoking(Geller et al., 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To explore students' tobacco dependence counseling experiences prior to medical school and their associations with tobacco counseling self-efficacy, and familiarity with and perceived effectiveness of tobacco dependence treatment among first-year medical students in the United States. Method: In 2010, 1266 first-year medical students from 10 US medical schools completed a survey reporting their clinical experiences with specific tobacco counseling skills (e.g., 5As) prior to medical school. The survey also included questions on tobacco counseling self-efficacy, perceived physician impact on smokers, and familiarity and effectiveness of tobacco-related treatments. Results: Half (50.4%) reported some tobacco counseling experiences prior to medical school (i.e. at least one 5A). Students with prior counseling experiences were more likely to have higher tobacco counseling self-efficacy, and greater familiarity with medication treatment, nicotine replacement treatment, and behavioral counseling for smoking cessation, compared to those with no prior experiences. Perceived physician impact on patient smoking outcomes did not differ by prior tobacco counseling experiences. Conclusions: Many first-year medical students may already be primed to learn tobacco dependence counseling skills. Enhancing early exposure to learning these skills in medical school is likely to be beneficial to the skillset of our future physicians.
    Full-text · Article · Feb 2015 · Preventive Medicine
    • "Smoking is a major one of the public health problems, causing many diseases such as chronic bronchitis, lung cancers and cardiovascular disease [1]. It seemed to be difficult to stop smoking, and so it often needs multiple attempts to quit and requires several repeated interventions [2]. Health professionals, especially family physicians (FPs), are the major part of providing for smoking cessation practice (SCP) [3]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Family physicians (FPs) are cornerstone for tobacco control. It was aimed to compare the effect of training on their smoking cessation practice, knowledge level and attitudes towards smoking and tobacco control. Methods and materials: The cross-sectional and multi-centered study was carried out using structured survey modified WHO based questionnaire. It was delivered to 1500 FPs randomly selected among approximately 23000 family physicians across the country. The study survey was self-reported by FPs, assessing their knowledge, attitudes, status of post-graduate training, and practice about tobacco control. Participants were assigned into two groups as non-trainee groups (Group 1) and post-graduate trainee (Group 2). Results: The mean age was 38.4 ± 7.1 years-old. The percentage of male and female FPs in the study was 53.1% and 46.9%. The ratio of family physicians who participated in training program Group 2) was 26.5% (n = 327). The ratio of female FPs who participated the SCP training course was significantly higher than that of male FPs (27.3% versus 22.5%, p = 0.035). There was no significant difference for smoking status between groups (p = 0.686). When the number FPs whose consulted by the smokers over ≥ 5 a week was compared, the ratio of FPs was significantly higher in group 2 than group 1 (p < 0.001), but overall ratio of FPs (2.8%) who consulted within a week smokers was considerably lower Statements of Competence and confidence items stated by all FPs were 24.2% and 32.2%, respectively. Physicians who had attended post-graduate training on SCP were more competent and confident, compared to non-trained FPs (p = 0.002 and p = 0.001). Conclusion: Post-graduate training on tobacco control improved self-confidence and competence of FPs. With post-graduate training, significant improvement was seen in practical skills of physicians. A continuing training program should be introduced to FPs, to engage them for smoking cessation practice.
    No preview · Article · Sep 2014 · International Journal of Clinical and Experimental Medicine
  • Source
    • "However, the response rate remains satisfactory for a mail-based survey with physicians [42-44]. In addition, socio-demographic characteristics of respondents are comparable to those reported in other surveys conducted among Canadian paediatricians [42,45]. Socio-professional characteristics of respondents also allow us to suppose a good representativeness. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In June 2009, the World Health Organization declared an A(H1N1) influenza pandemic. In October 2009, the largest vaccination campaign in Canadian history began. The aim of this study was to document paediatricians' knowledge, attitudes and practices (KAP) regarding A(H1N1) pandemic influenza and its prevention by vaccination just after the beginning of the A(H1N1) vaccination campaign and to compare the results with those obtained before campaign initiation. A self-administered mail-based questionnaire was sent to all Canadian paediatricians. Questionnaires were analyzed in two subsets: those received before and after the beginning of the vaccination campaign. Overall the response rate was 50%. Respondents' characteristics were comparable between the two subsets. Before the beginning of the campaign, 63% of paediatricians perceived A(H1N1) pandemic infection as a serious disease, that would occur frequently without vaccination compared to more than 75% after. Before the vaccination campaign, half of respondents or less thought that the A(H1N1) vaccine was safe (50%) and effective (35%) compared to 77% and 72% after. The proportion of paediatricians who reported they had received sufficient information on A(H1N1) vaccine increased from 31% before to 73% after the beginning of the vaccination campaign. The majority of respondents intended to get vaccinated against A(H1N1) influenza themselves (84% before and 92% after). Respondents' intention to recommend the A(H1N1) vaccine to their patients increased from 80% before the beginning of the campaign to 92% after. In multivariate analysis, the main determinants of paediatricians' intention to recommend the A(H1N1) vaccine were their intention to get vaccinated against A(H1N1) influenza themselves and a belief that A(H1N1) vaccine would be well accepted by health professionals who administer vaccines to the public. Results of this study show important increases in physicians' level of confidence about A(H1N1) vaccine's safety and immunogenicity and their willingness to recommend this vaccine to their patients. These changes could be explained, at least partially, by the important effort done by public health authorities to disseminate information regarding A(H1N1) vaccination.
    Full-text · Article · Feb 2011 · BMC Public Health
Show more