2012 johns hopkins bloomberg school of public health prof. javaid khan frcp (edin) head section of...

2012 Johns Hopkins Bloomberg School of Public Health

Prof. Javaid Khan FRCP (Edin)Head Section of Pulmonary and Critical Care Medicine The Aga Khan University, Karachi, Pakistan

Involving Health Professionals in Tobacco ControlInvolving Health Professionals in Tobacco Control


Involving Health Professionals in Tobacco Control

Why involve health professionals in tobacco control?

What are the barriers to involving health professionals in tobacco control?

What are practical examples of the ways in which health professionals can contribute in tobacco control?

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Which Health Professionals?

Medical, nursing, dental, and pharmacy students

Deans, principals, and professors of these schools

Midwives

Hospital employees

Clinic employees

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Doctors and the Tobacco Industry

Doctors have a very important marketing value

Tobacco industry used doctors for promoting tobacco in 1950s

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Image source: www.tobaccodocuments.org


Video: What Cigarette Do You Smoke, Doctor?

1. Click this link to view the video:

http://www.youtube.com/watch?v=hxUZI0vE0FM

2. After viewing the video, return to this slide, and click Play to continue the lecturepresentation.

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At this point in the presentation, you will view an online video that will appear in another browser window.

Follow these steps to view the video and then return to this lecture.


Video: What Cigarette Do You Smoke, Doctor?

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The Potential of Doctors to Change Patient Behavior

Doctors have probably the greatest potential of any group in society to promote reduction in tobacco use, and thus cause a reduction in tobacco-induced morbidity and mortality

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Source: Simpson. (2000). Doctors and tobacco: Medicine’s big challenge.


Health Professionals Are in a Powerful Position

Respected position in society

In the front line in dealing with health consequences of tobacco use

Unique opportunities to give advice to patients

Considered “expert” on health-related issues

Lines of access to decision makers

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Barriers to Involving Health Professionals

Barriers to involving health professionals in tobacco control Health professionals extremely busy in their clinical

work Tobacco use is not considered as a serious public health

issue in the country High smoking rates in health professionals Low perception of risk among the public Most health professionals do not receive any training on

tobacco control/smoking cessation in their medical schools

Many health professionals are not aware of how certain policies/legislation affect their ability to help patients quit tobacco

Poor health care infrastructure in many low-income countries

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Health Professionals and Smoking

Credibility of anti-smoking message is lost if public see health professionals smoking

Overall the current smoking prevalence among Chinese physicians differed significantly by gender Men: 26% to 61% Women: 0% to 19%

In countries with the highest smoking rates, doctors smoke even more than the general public and, as a result, serve as negative role models

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Text source: Abdullah et al. (2011). Tob Control, 22(1): 9-14. Image source: Javaid Kahn.


Global Health Professionals Survey Pilot Study, 2005

Surveys conducted in ten countries among third-year students in four health-professional disciplines (dentistry, medicine, nursing, and pharmacy)

Results indicated that current cigarette smoking among these students was higher than 20% in seven of the ten countries surveyed

87%-99% of the students surveyed believed they should have a role in counseling patients to quit smoking

Only 5%-37% of students had actually received formal training in how to conduct such counseling

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Source: Centers for Disease Control and Prevention (2005). Tobacco use and cessation counseling—Global health professionals survey pilot study, 10 countries, 2005. MMWR, 54(20): 505-509.


Health Professionals Must Not Forget Other Measures

Prevention of smoking-related diseases in society demands more than just smoking cessation Comprehensive ban on tobacco advertising and

promotion Mass media campaign Powerful pictorial health warnings Implementation of clean air laws Increase taxation on tobacco Preventing the youth from tobacco experimentation

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Why Doctors Don’t Discuss Tobacco with Patients

Too time-consuming

Advice is ineffective

Lacking confidence

Discussions are unpleasant

Knowledge is deficient

Discussing smoking is outside of their professional duty

Intrudes upon patients’ privacy

Discussions are inappropriate

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Source: Vogt. (2005). Addiction, 100(10): 1423-1431.


How Can Health Professionals Contribute?

Acting as a role model by not smoking, or by quitting smoking

Counseling patients not to smoke

Providing smoking cessation treatment

Speaking out publicly and lobbying for comprehensive public policies to control tobacco use

Using professional societies and medical associations as pressure groups for implementation of tobacco control laws

Doing research related to tobacco control in the country

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Source: American Cancer Society. (2003). Engaging doctors in tobacco control: Volume 2 of tobacco control strategy planning, companion guide.


What Can Clinicians Do?

Do not smoke or use other forms of tobacco

Take a smoking history from every patient

Give firm advice to patients on quitting smoking

Learn “how to counsel patients” in order to make them quit smoking

Educate the public regarding the hazards of active and passive smoking

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Future Professionals

Medical, nursing, pharmacy, and dental students must be taught about tobacco control and smoking cessation

Smoking rates in medical students is very high in many countries of the world

Curriculum is deficient in tobacco control and smoking cessation

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Text source: Richmond. (1999). Thorax, 54(1): 70-78; Image source: Javaid Kahn.


Does Advice from Doctors Encourage Smokers to Quit?

Advice from doctors helps people to quit

Even brief advice of 2-3 minutes about quitting smoking works

More intensive advice results in slightly higher rates of quitting

Providing follow-up support after offering the advice may increase quit rates

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Source: Stead et al. (2008). Cochrane Database of Syst Rev (2): CD000165.


The 5 A’s of Tobacco Cessation

Ask about tobacco use

Advise all users to quit

Assess willingness to make a quit attempt

Assist in quit attempt

Arrange for follow-up

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Health Professionals Lobbying for Tobacco Control

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Image source: Javaid Khan.


Lobby to Make Your Hospital and Clinics Smoke-Free

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Let’s Get Our Own House in Order

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2012 Johns Hopkins Bloomberg School of Public Health 22

Raising Voice on Non-Implementation of Clean Air Laws


Educating Public Using Print Media

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Educating Public Using Print Media

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Writing Letters to Editors and Appearing on Television

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Image sources: (left) Javaid Kahn, (right) courtesy of Health TV Pakistan.


Health Professionals With Politicians at Press Club

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Role of Medical Professional Societies

Train members as tobacco control advocates

Include tobacco as an issue in conferences

Exert pressure on decision makers for tobacco control measures in the country

Ensure that all conferences are smoke-free

Create public awareness of tobacco industry tactics

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Role of Medical Professional Societies

Issue brochures and guidelines on smoking cessation in local languages

Hold workshops for doctors on tobacco control and smoking cessation

Help organize talk shows on the tobacco epidemic

Encourage medical leaders to write letters and articles to newspapers

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Local Research

Health professionals must do local research to seek public attention

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At Medical School Level

Introduce tobacco control and smoking cessation in medical curriculum

Professors can use their status to speak out about the importance of tobacco control

Do research related to tobacco control

Raise issue of tobacco on World No Tobacco Day, World Cancer Day, etc.

Run smoke-free doctors and medical school campaign

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Training Future Health Professionals

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Quit Smoking!

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Thank You!

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2012 johns hopkins bloomberg school of public health prof. javaid khan frcp (edin) head section of...

Documents

health professionals

tobacco control slide

serious public health

tobacco industry doctors

tobaccoinduced morbidity

clinical work tobacco

potential of doctors

online video