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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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413328. [PMID: 34948936 PMCID: PMC8705497 DOI: 10.3390/ijerph182413328] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. METHODS PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. RESULTS Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. CONCLUSION Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.
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Affiliation(s)
- Anaïs Besson
- Family Medicine, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (A.B.); (A.T.)
| | - Alice Tarpin
- Family Medicine, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (A.B.); (A.T.)
| | - Valentin Flaudias
- Univ Angers, Laboratoire de psychologie des Pays de la Loire, Université de Nantes, LPPL, EA 4638, F-44000 Nantes, France;
| | - Georges Brousse
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont–Ferrand, France; (G.B.); (C.L.)
| | - Catherine Laporte
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont–Ferrand, France; (G.B.); (C.L.)
| | - Amanda Benson
- Sport Innovation Research Group, Department of Health and Biostatistics, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
| | - Valentin Navel
- CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Jean-Baptiste Bouillon-Minois
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Emergency Medicine, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Correspondence: ; Tel.: +33-6-74-36-04-23; Fax: +33-4-73-27-46-49
| | - Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, F-63000 Clermont-Ferrand, France;
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Moussa N, Kacem JH, Gargouri R, Kallel N, Kammoun S. Clinico-radiological particularities of common pulmonary tuberculosis among smokers in Tunisia. LA TUNISIE MEDICALE 2021; 99:638-643. [PMID: 35244916 PMCID: PMC8795993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
INRODUCTION Smoking and tuberculosis are two major public health issues worldwide, particularly in emerging countries. Currently, the relationship between these two scourges is well established. AIM Describe the clinical, radiological and progressive features of common pulmonary tuberculosis in smokers. METHODS Comparative study, carried out at the Pneumology department of the Hédi Chaker in Sfax, Tunisia, including 120 patients hospitalized for common pulmonary tuberculosis from January 2014 to December 2016 and who completed their follow-ups for a minimum period of 2 years . The patients were divided into 2 groups: Group1 (G1) consisting of 60 smoking patients and Group 2 (G2) consisting of 60 non-smoking patients. To assess the severity of radiological lesions, we used the International Labour Organization classification for simple pneumoconiosis and the Brouet classification. RESULTS The mean age of the patients was comparable in the two groups with a predominance of male for G1 (91%) and female for G2 (70%). The smokers consulted later (113 days versus 60 days (p=0.023). Dyspnea, hemoptysis and chest pain were significantly more frequent in the smokers. The radiological lesions were more serious in smoking group. Bilateral lesions were more observed in smokers (58% vs 25% p = 0.004). A positive association was noted between the extent of radiological lesions, stage 3 and 4 according to the Brouet classification, and smoking status (p <0.001). Similarly for the International Labour Organization classification for simple pneumoconiosis , the radiological lesions were more severe (scores 6 - 15) in the smokers (p <0.001).Smoking was associated with poor adherence (p <0.008), prolonged anti-tuberculosis treatment (p <0.001), delayed RBK negativation in sputum (p <0.001), and more frequent reactivation of tuberculosis (p=0.001). After the diagnosis of CPT, 83% of patients continued to smoke at the same rate and only 7% of patients had quit smoking. CONCLUSION Smoking worsens CPT by making the clinical picture noisier, radiological lesions more aggressive, negativation of BK in sputum later, and reactivation of CPT more frequent.
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Affiliation(s)
- Nadia Moussa
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Jihene Haj Kacem
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Rahma Gargouri
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Nessrine Kallel
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Samy Kammoun
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
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Zvolska K, Pankova A, Nohavova I, Huque R, Elsey H, Boeckmann M, Sheikh A, Siddiqi K, Kralikova E. A narrative review of facilitators and barriers to smoking cessation and tobacco-dependence treatment in patients with tuberculosis in low- and middle-income countries. Tob Induc Dis 2020; 18:67. [PMID: 32818030 PMCID: PMC7425757 DOI: 10.18332/tid/125195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/07/2020] [Accepted: 07/10/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking is a substantial cause of premature death in patients with tuberculosis (TB), particularly in low- and middle-income countries (LMICs) with high TB prevalence. The importance of incorporating smoking cessation and tobacco-dependence treatment (TDT) into TB care is highlighted in the most recent TB care guidelines. Our objective is to identify the likely key facilitators of and barriers to smoking cessation for patients with TB in LMICs. METHODS A systematic search of studies with English-language abstracts published between January 2000 and May 2019 was undertaken in the EMBASE, MEDLINE, EBSCO, ProQuest, Cochrane and Web of Science databases. Data extraction was followed by study-quality assessment and a descriptive and narrative synthesis of findings. RESULTS Out of 267 potentially eligible articles, 36 satisfied the inclusion criteria. Methodological quality of non-randomized studies was variable; low risk of bias was assessed in most randomized controlled studies. Identified facilitators included brief, repeated interventions, personalized behavioural counselling, offer of pharmacotherapy, smoke-free homes and a reasonable awareness of smoking-associated risks. Barriers included craving for a cigarette, low level of education, unemployment, easy access to tobacco in the hospital setting, lack of knowledge about quit strategies, and limited space and privacy at the clinics. Findings show that the risk of smoking relapse could be reduced through consistent follow-up upon completion of TB therapy and receiving a disease-specific smoking cessation message. CONCLUSIONS Raising awareness of smoking-related health risks in patients with TB and implementing guideline-recommended standardized TDT within national TB programmes could increase smoking cessation rates in this high-risk population.
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Affiliation(s)
- Kamila Zvolska
- Centre for Tobacco-Dependent, Third Department of Medicine, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alexandra Pankova
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Centre for Tobacco-Dependent, Third Department of Medicine, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Iveta Nohavova
- Centre for Tobacco-Dependent, Third Department of Medicine, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Rumana Huque
- Department of Research and Development, ARK Foundation, Dhaka, Bangladesh
| | - Helen Elsey
- Department of Health Sciences, University of York, York, United Kingdom
| | - Melanie Boeckmann
- Department of Environment and Health, School of Public Health, Bielefeld University, Bielefeld, Germany.,Department of Health Sciences, University of York, York, United Kingdom.,Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
| | - Eva Kralikova
- Centre for Tobacco-Dependent, Third Department of Medicine, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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[Tobacco smoking and stopping smoking interventions in patients with TB]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:391-399. [PMID: 30316651 DOI: 10.1016/j.pneumo.2018.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/01/2018] [Accepted: 09/10/2018] [Indexed: 02/08/2023]
Abstract
Tuberculosis and tobacco smoking are two major public health problems causing significant mortality worldwide. Tobacco smoke increases the risk of Mycobacterium tuberculosis infection, severe pulmonary or extrapulmonary TB, and death of TB. In emerging countries, quitting smoking is one way to control the TB epidemic. Compared with non-smokers, smokers with tuberculosis are less observant of anti-tuberculosis treatment. Smoking abstinence improves the course of their illness, the treatment compliance and facilitates the final cure justifying smoking cessation interventions. The involvement of all healthcare professionals in helping smokers stopping smoking is required.
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Underner M, Perriot J, Peiffer G, Meurice JC, Dautzenberg B. Tabagisme et observance du traitement antituberculeux. Rev Mal Respir 2016; 33:128-44. [PMID: 26777112 DOI: 10.1016/j.rmr.2015.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 08/31/2015] [Indexed: 02/08/2023]
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Aziza R, Sanae H, Hatim K, Bourkadi JE. Pulmonary tuberculosis specificities in smokers. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2015. [DOI: 10.1016/j.ejcdt.2015.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Daix A, Bakayoko-Yéo A, Koné Z, Samaké K, Coulibaly G, Touhon O, Domoua K. Connaissances et attitudes des médecins ivoiriens vis-à-vis du tabagisme chez les patients atteints de tuberculose. Rev Mal Respir 2015; 32:513-8. [DOI: 10.1016/j.rmr.2014.04.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 04/21/2014] [Indexed: 10/24/2022]
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Jiménez-Ruiz CA, Andreas S, Lewis KE, Tonnesen P, van Schayck CP, Hajek P, Tonstad S, Dautzenberg B, Fletcher M, Masefield S, Powell P, Hering T, Nardini S, Tonia T, Gratziou C. Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit. Eur Respir J 2015; 46:61-79. [PMID: 25882805 DOI: 10.1183/09031936.00092614] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 12/24/2014] [Indexed: 12/18/2022]
Abstract
Chronic obstructive pulmonary disease (COPD), lung cancer, asthma and pulmonary tuberculosis are common pulmonary diseases that are caused or worsened by tobacco smoking. Growing observational evidence suggests that symptoms and prognosis of these conditions improve upon smoking cessation. Despite increasing numbers of (small) randomised controlled trials suggesting intensive smoking cessation treatments work in people with pulmonary diseases many patients are not given specific advice on the benefits or referred for intensive cessation treatments and, therefore, continue smoking.This is a qualitative review regarding smoking cessation in patients with COPD and other pulmonary disorders, written by a group of European Respiratory Society experts. We describe the epidemiological links between smoking and pulmonary disorders, the evidence for benefits of stopping smoking, how best to assess tobacco dependence and what interventions currently work best to help pulmonary patients quit. Finally, we describe characteristics and management of any "hardcore" smoker who finds it difficult to quit with standard approaches.
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Affiliation(s)
| | - Stefan Andreas
- Lungenfachklinik Immenhausen and Pneumology, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Keir E Lewis
- Dept of Respiratory Medicine, Prince Philip Hospital and Swansea College of Medicine, Swansea, UK
| | - Philip Tonnesen
- Dept of Sleep Medicine, Glostrup Hospital, Glostrup, Denmark
| | - C P van Schayck
- Care and Public Health Research Institute (Caphri), Maastricht University, Maastricht, The Netherlands
| | - Peter Hajek
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Serena Tonstad
- Section for Preventive Cardiology, Oslo University Hospital, Oslo, Norway
| | | | | | | | | | | | - Stefano Nardini
- Pulmonary and TB Unit, Ospedale Civile, Vittorio Veneto, Italy
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | - Christina Gratziou
- University Centre for Research and Smoking Cessation, Evgenidio Hospital, Medical School, Athens University, Athens, Greece
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Randriatsarafara FM, Vololonarivelo BEE, Rabemananjara NNG, Randrianasolo JBO, Rakotomanga JDDM, Randrianarimanana VD. [Factors associated with tuberculosis in children at the University Hospital Centre Mother-Child Tsaralalàna, Antananarivo: a case-control study]. Pan Afr Med J 2014; 19:224. [PMID: 25838852 PMCID: PMC4374895 DOI: 10.11604/pamj.2014.19.224.4676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction A Madagascar, la tuberculose reste un problème de santé publique majeur, l'incidence s’élevant à 16% depuis 2009. Le présent travail a pour objet d'identifier les facteurs de risque de tuberculose chez l'enfant. Méthodes Nous avons mené une étude rétrospective de type cas-témoins sur les facteurs de risque de la tuberculose chez les enfants de 0 à 15 ans au Centre Hospitalier Universitaire Mère-Enfant de Tsaralalàna, de Janvier 2009 à Décembre 2011. Les enfants diagnostiqués de tuberculose dont le diagnostic a été retenu par des éléments de certitude ou par le score pédiatrique de la tuberculose représentent les cas. Les enfants hospitalisés durant la même période, non tuberculeux et de même âge, sont classés témoins. L'Odds Ratio quantifie les associations. Résultats Au total, 91 cas et 173 témoins ont été inclus. Parmi les cas, 73,62% présentent une malnutrition. De fortes associations sont démontrées avec: la malnutrition sévère (OR=6 (IC95% 2,43-15,61 (p<10-5))); le contage tuberculeux (OR=4,71 (IC95% 1,76-12,7 (p=0,003))); la non vaccination par le BCG (OR=4,21 (IC95% 1,99-8,99 (p < 2.10-5))); le niveau intellectuel maternel bas (OR=4,17 (IC95% 0,67-28,14 (p=0,06))); la taille de la fratrie à partir de 5 (OR=4,5). Des associations faibles sont retrouvées pour les autres facteurs étudiés. Les cas présentent une létalité de 18,7% contre 6,3% chez les témoins (p<10-5); 64,7 % des décès sont dus aux formes méningées. Conclusion La tuberculose reste un fléau chez les enfants, avec une lourde responsabilité de la pauvreté rassemblant presque tous les facteurs sus-cités.
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Affiliation(s)
- Fidiniaina Mamy Randriatsarafara
- Service Technique de la Direction Centrale du Service de Santé Militaire B.P 10 Ampahibe Antananarivo ; Département de Santé publique, Faculté de médecine, Université d'Antananarivo
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Potential impact of a pilot training program on smoking cessation intervention for tuberculosis DOTS providers in Malaysia. J Public Health (Oxf) 2009. [DOI: 10.1007/s10389-009-0302-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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