Tobacco Documents Online

180 I us are those questions concerned with the physi- cilris perception of his responsibility to his patients. and of his behavior with them in relationship to smoking and health. Before reporting these results, I.vould like to mention some findings obtained two years ago from a sample of the general public. The,v very definitely look to the physician for help in smoking problems. About two of three in a national sample interviewed about two years ago agreed that it is the doctor's job to convince his patients to stop smoking (63 per cent), that doctors should set a good example by notsmol.-ing (69 per cent), and that they should be active in making speeches to the general public about the harmfulness of cigarette smoking (69 per cent). Also, 75 per cent felt that if a patient wants to quit, it is the doctor's job to help, and 84 per cent believe that most patients will not quit unless the doctortells them to do so. How do these opinions agree .vith those of doc- tors? The results of the recent physician survey indicate that an overwhelming majority of the doc- tors polled (i r per cent) a-reed with the statement "It is the physician's responsibility to attempt to convince his patients to stop smoldng." An even larger proportion (86 per cent) agreed that if a patient wants to stop smoking, it is the physician's like the mail respondents. Of particular interest to spondents were like the nonrespondents rather tha appropriately weighted, assuming the telephone re these calls. The results of the telephone calls .vere telephone interviews; 283 cases were derived from ., A ,r~ recently completed survey conducted by the A h'ational Opinion Besearch Center attempted to answer a number of questions regarding physi- cians' opinions about smoking and health. A ques- tionnaire was sent to a random sample of-5,000 practicing physicians drawn from a universe of 249,569.~ 1 all, three mailings were made, with a total of 1,5-16 responding to one of the three mail- ings. A sample of nonrespondents was followed by Physicians' Attitudes Toward Their InvoEvernent in Smoking Problems of Patients* Dorothy E. Green, Ph.D.,°° and Daniel Horn, Ph.D.f 'Presented at the National Forum on OFr'ice Mana.¢ement of Smoldng Problerns, Marriott \lotor Hotel, Chicago, Illinois, April 11, 1968. '•Chief, Program Research Section. }Director. National Clearins?:ouse for Smokine and Health, National Center for Chronic Disease Control, Bureau of Disease Prevention and Environmental Con- trol, Public Health Service, U. S. Department of Health, Education, and Welfare, Arlington, Virginia 12 TITX 0004135 C +F Nt tc o p:,p responsibility to help him accomplish this. Seventy- two per cent agreed with the statement "It is the physician's responsibilit,v to set a good example b;• not smoking ci~arettes." Two of three think ph~-- sicians should be more active in speaking before lay groups about cigarette smol:iny .>. Physicians unquestionably recognize cigarette smoking as a serious health hazard. NIore than 90 per cent associate smokincr with chronic bronchitis, lung cancer and emphysema, and almost as many associate it with peripheral vascular disease and cor- onary artery disease. About three of four physicians associate cigarette smoking with Ianmgeal cancer, leukoplakia of the mouth vid lips, and oral cancer_ OnIy about half of them indicate that smoking is associated with any soft tissue lesion of the lip and mouth,_and only one-fourth associate it with blad- der cancer, indicating a much lower acceptance of the significance of any relationship between cija- rette smoking.and these conditions. NIost physicians, then, do see cigarette smoking as a health hazard and feel responsible for changin,- their patients' smoking behavior. What do they do? The doctors were asked the following question: "Among your cigarette-smok.ing patients who do not have any condition related to smolcing, ho« many do you advise to give up cigarettes (or cut• down sharply) as a general health precaution?" and were asked to reply by sa}'ing all, almost all (95-99 per cent), most (65-9.5 per cent), etc., down to none. This question was followed by a similar ques- tion asking about the proportion of patients witlr each of a number of specific conditions who n•ere given this advice. Looking only at the proportion of doctors giving this advice to °all" or "almost alI" (95-100 per cent) of their patients,.we find that 33 per cent of thee physicians say that they advise all o,- almost all of their patients who do not have an,v con- dition related to smoking to quit or to cut do«•n. This is in sharp contrast to the proportion--SS per cent who give this advice to their patients .vith lung and pulmonary conditions. Other conditions, and proportions of doctors giving advice to all or al- most all patients, to quit or to cut down, are (in descending order): peripheral vascular disease, 81 per cent; heart condition, i-i'per cent; upper respir- atory condition, 73 per cent; peptic ulcers, 71 per cent; mouth or lip lesion, 71 per cent. On the other DIS. CHEST, VOL. 54, NO. 3, SEPTEMBER 1968