doctors in turkey smoke more sahin em, ozer c, dagdeviren n, akturk z trakya university faculty of...
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Doctors In Turkey Smoke More
SAHIN EM, OZER C, DAGDEVIREN N, AKTURK Z
Trakya University
Faculty of Medicine
Department of Family Practice
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BACKGROUND
Smoking is a major health problem in Turkey. The smoking prevalence is 43,6%.
1988
☞ 25.000.000 smokers!
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Medical practice of physicians may be affected by their life styles .
Physicians who smoke may have difficulty in promoting healthy behavior among their patients.
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METHODS
Attitudes and behaviors of the doctors in Trakya University Hospital about smoking were EVALUATED a questionnaire.
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The questionnaire consisted of 29 items.
Demographic parametersAssessing smoking habitsAssessing nicotine dependency
(Fagerström)Opinions about smoking cessation
counseling
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The research was completed in May 2000 .
Descriptive Cross-sectional
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Of 400 doctors in the hospital 132 participated.
Questionnaires were delivered and collected by students.
The results were analyzed in computer.
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RESULTSDEMOGPHIC PARAMETERS
GENDER 72,5% male 27,5% female
AGE mean age 33,648,36 (min:24, max:64).
MARITAL STATUS 63,8%married, 34,4 % single 1,4% divorced.
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GENDER
male%72
female%28
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AGE
Age
656055504540353025
Nu
mb
er
of
ca
se
s
60
50
40
30
20
10
0
Std. Dev = 8,36
Mean = 34
N = 132,00
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MARITAL STATUS
divorced1%married
64%
single35%
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ACADEMIC POSITION
12 professors (8,7%) 9 associate professors (6,5%) 24 assistant professors (17,4%) 10 specialists (7,2%) 83 residents (60,1%)
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OCCUPATION
academics%33
residents%60
specialists%7
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SMOKING HABITS
N %
Non-smokers 55 41,6
Ex-smokers 17 12,9
Smokers 60 45,5
TOTAL 132 100
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SMOKING HABITS
0
10
20
30
40
50
% 41,6 12,9 45,5
non-smokers ex-smokers smokers
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SMOKING DANSITY
4115N =
gender
malefemale
Mean +
- 1 S
E N
um
ber
of cig
are
ttes s
moked d
aily
20
19
18
17
16
15
14
13
12
11
10
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PREFERED TYPE OF CIGARETTES
filtered %41
filtered light%59
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WHEN THEY START SMOKING?
0
20
40
60
% 25,9 54,3 14,8 5
after graduation
facultyhigh
schoolprimary school
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THE REASONS OF STARTING
32,4
26,7
12,79,9
74,2
7,1
0
5
10
15
20
25
30
35P
eer
fact
or
Str
ess
Inte
rest
Imita
tion
Enj
oym
ent
Bor
edom
Oth
ers
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STAGES of SMOKING CESSATION
N %
Precontemplation 31 40,8
Contemplation 4 5,3
Preparation 25 32,8
Action 6 7,9
Maintenance 10 13,2
TOTAL 76 100
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Fagerström nicotine dependency test
N %
Minimally dependent 39 73,5
Moderately dependent 2 3,8
Highly dependent 12 22,7
Total 53 100,0
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SMOKING CESSATION COUNSELING
Smoking related diseases
N %
All 82 77,4
>70% 9 8,5
30%-70% 5 4,7
<30% 5 4,7
None 5 4,7
TOTAL 106 100
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SMOKING CESSATION COUNSELINGDiseases not related to smoking
N %
All 38 39,6
>70% 15 15,6
30%-70% 14 14,6
<30% 12 12,5
None 17 17,7
TOTAL 96 100
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Physicians should give smoking cessation counseling in every visit.
0
10
20
30
40
50
60
% 58,6 34,6 3,8 2,3 0,8
strongly agree
agree undecided disagreestrongly disagree
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Smoking cessation counseling is a responsibility for every physician.
0
10
20
30
40
50
60
% 33,8 58,6 1,5 4,5 1,5
strongly agree
agree undecided disagreestrongly disagree
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I could manage smoking cessation counseling.
0
10
20
30
40
50
% 39,4 41,7 13,6 2,3 3
strongly agree
agree undecided disagreestrongly disagree
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More physicians will provide smoking cessation counseling if they know there is an
effective tool for guiding to quit.
0
10
20
30
40
50
60
% 51,9 33,8 6 6,8 1,5
strongly agree
agree undecided disagreestrongly disagree
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In our hospital, there is a need for a special unit that provides smoking cessation counseling and treatment.
0
10
20
30
40
50
60
70
% 67,9 23,7 6,1 0,8 1,5
strongly agree
agree undecided disagreestrongly disagree
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Do you ask all your patients their smoking behavior?
%65
%35
yes no
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ANTI-SMOKING LEGISLATION
• “Smoking is forbidden in closed public places”
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What is the success rate of anti-smoking legislation in practice?
0
10
20
30
40
50
60
70
ofice area hospital area educationalarea
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Do you smoke in practice?
0 10 20 30 40 50 60
never
very rare
rare
often
% 56,5 12,9 19,4 4,8
never very rare rare often
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CONCLUSIONS
Smoking prevalence in our research was found high as similar to previous trials made in Turkey
☞(45,5%) of the participants were smoking.
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Smokersİzmir1981
Akgün 57%
Elazığ1988
Sezer 48%
Samsun1993
Önder 29,7%
İzmir1994
Öncel 48%
Manisa1999
Esen 41,5%
Edirne 2000
Şahin 45,5%
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Non-smokers
Ex-smokers
Smokers
UK+Ireland 2000
Basnyat 53 37 10
Mexica 1997
Tapia-Conyer
52,5 20,6 26,9
Israel 1997
Samuels 66,3 17,9 15,8
Italy 1998
Zanetti 42 19 39
Bahrain 1999
Hamadeh 45,3 18,8 35,9
Turkey 2000
Sahin 41,6 12,9 45,5
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The smoking prevalence of doctors in our research was same with the population
population doctors
43,6% 45,5%
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Smoking cessation counseling rate is not enough because our participants don’t know much about it.
– “More physicians will provide smoking cessation counseling if they know there is an effective tool for guiding to quit“ (90% agreed)
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There is a need for mobilizing tobacco control efforts.
Our study reveals the smoking prevalence of doctors in different ages, sexes and specialties.
It can be helpful in designing anti-tobacco efforts and assessing their efficacy.
We believe anti-tobacco efforts sould start with education of physicians.
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Take Home Messages
• Turkish doctors smoke more than their collegues in the world
• They are not motivated to quit smoking
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Doctors In Turkey Smoke More
SAHIN EM, OZER C, DAGDEVIREN N, AKTURK Z
Trakya University
Faculty of Medicine
Department of Family Practice