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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

Physicians' approach toward tobacco cessation in Kerala, India

AS Pradeepkumar, MBBS, MPH1, Sailesh Mohan, MD, MPH1, CU Thresia, PhD1, KR Thankappan, MD, MPH1, Mimi Nichter, PhD2, Mark Nichter, PhD2, CK Haddock, PhD3, and Harry A. Lando, PhD4. (1) Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College PO, Trivandrum, 695011, India, (2) Anthropology, University of Arizona, 1009 E. South Campus Drive, Tucson, AZ 857210030, (3) Department of Psychology, University of Missouri - Kansas City, Kansas City, MO 64110-2499, (4) Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454-1015

Objective: Even though the medical community can play a key role in enhancing quit rates, little is known about whether physicians in India address tobacco use in their patients. Thus, we assessed physician behavior in Kerala, India in promoting tobacco cessation and their need for training in cessation skills.

Methods: A cross sectional survey was conducted among 110 male medical school physicians and 229 health service physicians (67% male) to determine their attitudes and practices regarding tobacco cessation and to assess their need for training in cessation skills in two districts. In addition, an exit interview was conducted among 915 patients (55.1% male) visited the similar hospitals to assess their experiences and expectations from physicians regarding tobacco cessation.

Results: Nearly three quarters of medical school and health service physicians reported that they ask and advise their patients on tobacco use. However, only one third of patients reported that they received such tobacco intervention from their physicians. The physician's behavior of inquiry regarding tobacco use of their patients varied with the presenting illness. More physicians intervene when patients have respiratory problems, cardiovascular problems, cancer or oral health problems compared to patients with diabetes, pregnant wives or small children. Only one third of the physicians felt that they had sufficient skills to promote quitting smoking. About 80% of male and 90% of female physicians were interested in receiving training in counseling skills. Training to enhance the tobacco intervention skills is needed to prevent missing of opportunities for effective intervention by physicians.