Doctors’ smoking, a true “barometer of smoking” in French society

While it is decreasing worldwide, smoking among doctors remains high in France. This smoking status of doctors makes them less effective in their smoking cessation advice. Some avenues are being considered to reduce smoking among caregivers.

Conducted by a team of researchers from Clermont-Ferrand, a 2021 meta-analysis highlighted a high prevalence of smoking among doctors worldwide[1]. This prevalence, estimated at 28 % before 1985 and 16 % after 2015, varies greatly depending on the continents, time periods, sex of the subjects and medical specialties. On average, there are 25 % smokers among students, 24 % among general practitioners, 18 % among surgeons and 16 % among specialists, compared to 11 % among anesthetists and 8% among pediatricians.

This trend is particularly marked in France, where a study conducted in 2021 among the staff of the Georges Pompidou European Hospital (HEGP) by Dr Anne-Laurence Le Faou indicates that 27% of doctors there are smokers.[2]A figure that recalls another study published in 2006, which placed the number of smoker general practitioners at 26,%, reflecting the persistence of a high prevalence of smoking in France.[3]Already at that time, the impact of smoking on the doctor-patient relationship and the need to strengthen the teaching of tobaccology in medical studies were highlighted.

Smoking doctors have more difficulty advising smoking patients

Asked by the Quotidien du Médecin about this smoking among doctors, Professor Daniel Thomas, spokesperson for the French-speaking Tobacco Society (SFT), believes that "It is a real 'barometer of smoking' as shown by the analysis of the temporal evolution of the prevalence of their smoking compared to that of the general population."

The physician's smoking status would influence his or her effectiveness in managing smoking cessation in patients. "For many caregivers who smoke, smoking affects their ability to address the issue of tobacco with patients, to advise them to quit and to provide practical and effective support to smokers in quitting.", continues Professor Thomas, "Because of denial, guilty conscience or the feeling of being in a difficult position, the smoking doctor is in some way handicapped in the care of the smoking patient." In fact, doctors who smoke are less likely to seek training in tobaccology and are therefore less equipped to manage smoking cessation. Doctors who have stopped smoking, on the other hand, would be more relevant in advising smokers in their cessation process.

The exemplary nature of caregivers in question

The exemplary nature of doctors or any other health professional has an impact on patients' behavior. The tobacco industry is aware of this and has made extensive use of the image of smoking doctors in its advertisements for supposedly less harmful cigarettes for several decades. Today, this industry is highlighting doctors to promote heated tobacco, presented as a risk reduction tool. Establishing that hospitals and all places of care are truly smoke-free spaces, and encouraging caregivers to think about their smoking status have been recurring themes for the past twenty years, but enormous progress remains to be made. The systematic integration of the knowledge necessary for treating smokers into the initial and continuing training of caregivers is one of the other areas for improvement called for.

"Today, all healthcare professionals should be non-smokers and create a tobacco-free environment around them", considers Professor Thomas. An objective that makes perfect sense if we want to succeed in having a Tobacco-Free Generation in 2032, which provides for less than 5% of children born since 2014 to be consumers of tobacco products.

Keywords: smoking, doctors, caregivers, exemplarity, Tobacco-Free Generation

©Tobacco Free Generation

M.F.

---

[1] Besson A, Tarpin A, Flaudias V, Brousse G, Laporte C, Benson A, Navel V, Bouillon-Minois JB, Dutheil F, Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis. Int. J. Approx. Res. Public Health (2021)18, 13328. [2] Acar AL, Smoking among caregivers: we need to do better, the Daily Doctor, published on November 18, 2022, consulted on November 21, 2022. [3] Underner M, Ingrand P, Allouch A, Laforgue A, Migeot V, Defossez G, Meurice J, Influence of general practitioners' smoking on their practice of providing minimal advice to help people quit smoking. Review of Respiratory Diseases (2006)23, 426-429. National Committee Against Smoking |