Background Smoking cessation advice by GPs is an effective and cost-effective intervention, but is not implemented as widely as it could be. Aim This wide-ranging Europe-wide literature review, part of the European Union (EU) PESCE (General Practitioners and the Economics of Smoking Cessation in Europe) project, explored the extent of GPs9 engagement in smoking cessation and the factors that influence their engagement. Method Two searches were conducted, one for grey literature, across all European countries, and one for academic studies. Data from eligible studies published from 1990 onwards were synthesised and reported under four categories of influencing factors: GP characteristics, patient characteristics, structural factors, and cessation-specific knowledge and skills. Results The literature showed that most GPs in Europe question the smoking status of all new patients but fewer routinely ask this of regular patients, or advise smokers to quit. The proportion offering intensive interventions or prescribing treatments is lower still. Factors influencing GPs9 engagement in smoking cessation include GPs9 own smoking status and their attitudes towards giving smoking cessation advice; whether patients present with smoking-related symptoms, are pregnant, or heavy smokers; time, training, and reimbursement are important structural factors; and some GPs lack knowledge and skills regarding the use of specific cessation methods and treatments, or have limited awareness of specialist cessation services. No single factor or category of factors explains the variations in GPs9 engagement in smoking cessation. Conclusion Strategies to improve the frequency and quality of GPs9 engagement in smoking cessation need to address the multifaceted influences on GPs9 practice and to reflect the widely differing contexts across Europe.

Factors influencing European GPs' engagement in smoking cessation: a multi-country literature review

Background: Greece has one of the highest rates of adult smoking globally. The objective of the present survey was to explore the epidemiology of tobacco use in Greece after the implementation of recent legislative tobacco control measures and to compare it with previous cross-sectional data from 2006. Methods: The nationwide household survey ‘Hellas Health III’ was conducted in 2010. A sample of 1000 adults (mean age 47.1 ± 17.1 years) were interviewed. Individuals who had smoked at least once during the past 30 days were classified as smokers. Results were compared with those from the similar ‘Hellas Health I’ study, which was conducted in 2006. Results: The prevalence of smoking was calculated at 41% (45% among men and 38% in women, P = 0.04). Greek men smoke more cigarettes (23.2 vs. 19.3 per day, P = 0.002), and they become regular smokers earlier in life. In age groups <55 years, most gender inequalities are attenuated. Socio-economic status does not affect tobacco use in Greece. In comparison with 2006, smoking prevalence, especially among young adults, has fallen from 48 to 35% in 2010. Moreover, a substantial reduction in the number of cigarettes smoked among all age groups was noticed. Conclusions : Trends in smoking prevalence and consumption among adults seem favourable in Greece during the past 4 years; a substantial reduction of younger smokers and in the number of cigarettes smoked among all age groups is documented. This constitutes a significant public health achievement and an indicator that young adults are a susceptible population to legislative action.

/pdf/prevalence-and-determinants-of-tobacco-use-among-adults-in-21seakm3dc.pdf

Prevalence and determinants of tobacco use among adults in Greece: 4 year trends.

Aims

To assess the association between doctors' smoking status and the use of the ‘5As’ of smoking cessation



Methods

A systematic search of 11 databases covering English and Spanish language publications since 1996 was undertaken Studies were included if they reported doctors' smoking status (current, former or never smoker) and rates of practising any of the 5As of smoking cessation (Ask; Advise; Assess; Assist; and Arrange) Frequencies and proportions were extracted from individual papers and risk ratios (RR) were calculated A random-effects meta-analysis model was used to assess the effect of the doctor's personal smoking history Covariate effects were explored using meta-regression for three pre-specified study characteristics: doctors' role, smoking prevalence of the sample and study quality



Results

Twenty studies were included in this systematic review The RR of always asking patients about their smoking was not associated significantly with doctors' smoking status [RR = 098; 95% confidence interval (CI) = 094–102; P = 0378; I2 = 000%; 10 studies] Meta-analysis suggested that doctors who were current smokers had a 17% increased risk of not advising their patients to quit compared with never-smokers (RR = 083; 95% CI = 077–090; P < 0000; I2 = 8214%; 14 studies) However, high levels of heterogeneity were found that were not explained by the meta-regression Regarding assisting patients to quit, never smokers were more likely to counsel than current smokers (RR = 092; 95% CI = 085–099; P = 0036; I2 = 000%; three studies) but less likely to make a referral (RR = 140; 95% CI = 109–179; P = 0009; I2 = 000%; five studies) No statistically significant differences were found in arranging future contact by smoking status (RR = 080; 95% CI = 052–123; P = 0315; I2 = 4703%; four studies)



Conclusions

Smoking status of doctors may affect their delivery of smoking cessation treatments to patients, with smokers being less likely than non-smokers or ex-smokers to advise and counsel their patients to quit but more likely to refer them to smoking cessation programmes

Do doctors' smoking habits influence their smoking cessation practices? A systematic review and meta-analysis

Background
Within the healthcare system, nurses have the ability to influence their patients' smoking habits through counselling. Therefore, it is of great importance to appropriately train health professionals on smoking cessation strategies with the aim to help them provide advice to their patients. In light of the above, the objective of this study was to assess the association between Greek nursing students' beliefs towards tobacco control/smoking cessation and the professional training received.

/pdf/nursing-education-and-beliefs-towards-tobacco-cessation-and-27ntnqchy0.pdf

Nursing education and beliefs towards tobacco cessation and control: a cross- sectional national survey (GHPSS) among nursing students in Greece

The present study targeted health care workers (HCWs) in Governmental Hospitals and Primary Health Care Centers in Abha City, southwestern Saudi Arabia. An anonymous self-report questionnaire was used to assess tobacco use and the reasons for smoking. The present study included 736 HCWs. The overall prevalence of tobacco use amounted to 26.3% (14.8% current and 11.5% former users). In a binary logistic regression analysis, males were found significantly more prone to smoke compared to females (aOR = 3.081, 95% CI: 2.004-4.739). Similarly, parental history of tobacco use was found to be a significant risk factor (aOR = 1.540, 95% CI: 1.040-2.278). Among current users, 89.9% were interested in quitting and 66.1% tried before to quit. The prevalence of smoking among HCWs in the present study, besides being a public health problem, represents a potential barrier in involving this group as a first line for tobacco control. There is a need for a national intervention programme in the country in a tailored manner for HCWs to control tobacco use parallel to the running national program for public. These interventions should begin early in basic medical education and to be applied continually during one's medical career.

/pdf/tobacco-use-among-health-care-workers-in-southwestern-saudi-16wi80z3fz.pdf

Tobacco Use among Health Care Workers in Southwestern Saudi Arabia

Smoking habits and associated factors among Greek physicians

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Smoking habits and associated factors among Greek physicians