Jessica A Allen and Dr. Gordon Lindsay, College of Health Science
Health care professionals play an important role in the reduction of tobacco demand through patient counseling, advocating public education programs, supporting legislation, and personal example. Dr. Bettina Piko (2005), in the Journal of Community Health, states that health care professionals are generally more aware of the adverse health consequences of smoking than the general population. Moreover the World Health Organizations Code of Practice on Tobacco Control for Health Professional Organizations calls for health professionals to lead by example and become involved in tobacco control as part of the public health agenda in his/her country.
Health professional involvement is especially important in developing nations that have not experienced the decrease in tobacco use that developing nations have experienced (Mohan et al, 2006). Due to this vital role it is important to gauge medical students’—future health professionals—habits, knowledge and attitudes towards smoking and ensure that they are being adequately instructed about problems related to smoking and cessation techniques.
Cambodia, this study’s area of research, has one of the highest male smoking rates in the world, where 67% of urban and 86% of rural males smoke (Mackay & Eriksen, 2002). This research is useful in determining whether medical students’ use of tobacco parallels that of society, and determine Cambodian medical student’s habits, knowledge and attitudes towards smoking as well as the school’s current smoking curriculum.
A survey was administered to 110 second-year medical students attending International University, one of two accredited medical schools in Phnom Penh, Cambodia’s capital city. The research process, as a whole, from the grant writing to the final report, provided plenty of learning opportunities such as developing and using effective communication skills, overcoming obstacles, learning research methods, and being patient and determined. However, this paper focuses mainly on the preliminary findings of the surveys results.
Preliminary analysis gives insight to the habits, knowledge and attitudes of the Cambodian medical students surveyed. Of the 110 students surveyed, 56 males and 54 females, only 13% had ever smoked, and the 8% that currently smoke are all are males.
In relation to the recommendations of the World Health Organization that physicians be examples and instruments in tobacco control, over 75% of surveyed students agree physicians serve as role models to their patients and the public, should set a good example by not smoking and should routinely ask about patient’s smoking habits. In addition more than 90% agree physicians should routinely advise their patients to stop smoking and should speak to community groups about smoking.
It was found that the majority of medical students agree passive smoking increases the risk of lung disease in non-smoking adults and increases the risk of lower respiratory tract illnesses such as pneumonia in exposed children. However more than 20% were unsure (1) if maternal smoking during pregnancy increases the risk of Sudden Infant Death, (2) neonatal death is associated with passive smoking or (3) passive smoking increases the risk of heart disease in non-smoking adults.
Over 70% of students agreed that the current medical training curriculum has prepared the student to ask about a patient’s smoking history, assess a patient’s willingness to quit smoking, counsel a patient on smoking cessation and follow up on a patient’s smoking habits. However when asked to consider the current medical curriculum and how much attention should be given to smoking, 86% responded more attention should be given.
In conclusion, the smoking habits of second-year Cambodian medical students do not mirror society and the majority agrees—like the World Health Organizations Code of Practice on Tobacco Control for Health Professional Organizations —that doctors and health professionals should set a good example by not smoking and be involved in tobacco control efforts. Recommendations for the medical school are that it focuses more attention on the effects of smoking and methods of smoking cessation in the curriculum. These recommendations stems from the opinions of the students themselves as well as students being unsure of some of the effects of smoking and passive smoking.