Barcelona, Spain
--Smoking Acknowledged as Chronic, Relapsing Medical Condition and Cited as Most Harmful Activity to Affect Long Term Health of Patients
-- Survey Reveals Significant Differences in Attitudes Between Non-Smoking and Smoking Physicians
A majority of physicians believe that smoking is the most harmful activity to affect their patients' long-term health by a considerable margin over lack of exercise, unhealthy diet, drinking alcohol and over-eating/obesity, according to results from one of the largest international surveys of physicians' attitudes to smoking and smoking cessation, presented today at the World Congress of Cardiology / European Society of Cardiology meeting in Barcelona, Spain. In fact, an overwhelming majority - 81 percent - consider smoking a chronic, relapsing, medical condition.
Despite this fact, over half of physicians surveyed do not have time to help smokers quit and 38% feel inappropriately trained, while 46% say they have other higher priorities to focus on. An overwhelming majority of physicians also agree that smoking is difficult to treat, more difficult than high blood pressure or high cholesterol and on a par with obesity. Although nearly all physicians acknowledge that smoking is an addictive behaviour, most also say the smoker is the individual with the most responsibility for quitting this addiction, rather than GPs themselves.
"What this survey highlights is the practical difficulties doctors face in helping their patients quit smoking," said Professor Robert West, Cancer Research UK. "Whilst the considerable health risks associated with smoking are now relatively well known, the realities of enabling people to stop are proving more challenging. It is vital that smokers receive practical support and advice for quitting smoking from their doctors, so it is important that lessons from findings such as these are learned."
Of note, there is a significant difference of opinion between physicians who smoke and those who do not. Only 57% of physicians who smoke stated "smoking" as the most harmful activity for their patients, compared to 73% of non-smoking physicians, suggesting some physicians who smoke may be underestimating the harmful effects of smoking.
Doctor-Patient Dialogues
Though a significant percentage of physicians say they discuss smoking with their smoking patients on every visit or occasionally, their discussions generally focus either on repeating widely available public health messages or information gathering rather than actually facilitating the quitting process. Only 47% help the smoker develop a plan to quit, 39% recommend an over-the-counter (OTC) medication and 29% prescribe a prescription medication. North American doctors are more proactive with 76% helping the smoker to develop a plan to quit and 57% prescribing a medication, compared to 43% and 21% respectively in Europe.
Again, the difference between physicians who smoke and those who do not is noticeable. While 43% of non-smoking doctors discuss smoking with their smoking patients at every visit, only 33% of doctors who smoke do the same. There are also significant differences globally, with the number standing at 68% of North American physicians (both smoking and non-smoking) compared to only 14% in Asia.
The vast majority of doctors understand why quitting smoking is so difficult. Nearly all of them agree that smoking is an addictive behaviour and 81% consider it a chronic, relapsing medical condition. Indeed, 71% agree that smoking should be classified as a medical condition and 64% believe that if this were to happen, it would encourage more smokers to quit.
"To successfully combat deaths caused by smoking, everybody, both physicians and non-physicians, need to reframe how we talk and think about smoking," said Professor Serena Tonstad, Department of Preventive Cardiology, Ulleval University Hospital, Norway. "Smoking is not a manifestation of a weak will or character, but a chronic relapsing medical condition caused by tobacco dependence. Many smokers may require medical treatment for this condition, because most smokers are addicted to inhaled nicotine. This addiction ultimately takes the life of one out of two smokers prematurely."
Potential Treatment Options
Physicians feel smokers themselves are the most responsible for quitting - this may be due to the fact that they do not have effective treatment options to take action such as they do for high blood pressure or elevated cholesterol. However, physicians may also be underestimating how many of their smoking patients are trying to quit. Physicians in the survey estimate that on average only 18% of their patients who smoke are trying to quit. In reality, approximately one third of smokers make a quit attempt each year.(1)
When asked what would make it easier for them to help smokers to quit doctors were very clear. They agreed that they want more effective medication (81%), additional coaching on how to communicate and motivate smokers to quit (78%), and more widely publicised smoking cessation success rates (77%).
"The current situation is a vicious circle - although doctors recognise the problems associated with smoking, they are underestimating the number of their smoking patients who are trying to quit and feel they have ineffective solutions to address the problem anyway," said Professor West. "As a result, they are putting the responsibility on the smoker to quit and it is known that less than 5% of smokers who attempt to quit unaided, remain abstinent at one year. If we are to make serious inroads into combating the world's leading preventable cause of premature death, we need to radically modify the way smoking is perceived and treated worldwide."
About STOP
STOP (Smoking: The Opinion of Physicians) survey, sponsored by Pfizer and conducted by Harris Interactive, is one of the largest global surveys conducted of General Practitioners' (GPs) and family physicians' attitudes to smoking and smoking cessation. Some 2,836 physicians from 16 countries were interviewed for the study. Physicians in Canada, France, Germany, Greece, Italy, Japan, Korea, Mexico, Netherlands, Poland, Spain, Sweden, Switzerland, Turkey, UK and US participated in the survey.
STOP was funded by Pfizer.
Definition of Regions
Asia = Japan, Korea
Europe = France, Germany, Greece, Italy, Netherlands,
Poland, Spain, Sweden, Switzerland, Turkey, UK
Latin America = Mexico
North America = Canada, USA
References
(1) World Health Organization. Policy Recommendations for Smoking Cessation and Treatment of Tobacco Dependence. 2003. Available online at
http://www.wpro.who.int/NR/rdonlyres/8D25E4D3-BB81-479E-8DF5-7 BAF674DB104/0/PolicyRecommendations.pdf. Last accessed August 2006
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CONTACT: Edelman PR for Pfizer Zoe Fleming +44 7949 735206
CONTACT: Edelman PR for Pfizer Zoe Fleming +44 7949 735206, ,
Source: Business Wire (Business Wire India)