A study of smoking and smoking cessation
on the curricula of UK medical schools.
Tobacco Control 2004 March ;13(1):74-77.
Roddy E, Rubin P, Britton J.
Division of Respiratory Medicine, School of Medical and Surgical Sciences, University of Nottingham, Nottingham, UK. Faculty of Medicine and Health Sciences, University of Nottingham. Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham.
OBJECTIVES: To identify current practice in teaching on smoking and smoking cessation in UK medical schools, and establish whether newly qualified UK doctors feel prepared to deliver smoking cessation interventions.
DESIGN: Search of published curricula from all UK medical schools; questionnaire surveys of all UK medical school deans and UK qualified pre-registration house officers (PRHOs).
PARTICIPANTS: Deans or nominated representatives from all 24 UK medical schools with current undergraduates, and all UK qualified PRHOs.
MAIN OUTCOME MEASURES: Inclusion and organisation in curriculum of 15 predefined core topics related to smoking (deans); perceived readiness to deliver smoking cessation interventions (PRHOs).
RESULTS: There was no mention of smoking or smoking cessation in the published curriculum material of 10 (42%) medical schools. Deans reported compulsory teaching on a mean (SD) of 9.5 (2.8) core topics, while PRHOs recalled compulsory teaching in only 6.6 (3.2). Training in clinical aspects of smoking cessation was particularly neglected, with 60% of PRHOs reporting that they graduated unable to deliver smoking cessation interventions in accordance with national guidelines. Only 17% of PRHOs felt well prepared to deliver advice on using nicotine replacement therapy, and 5% on bupropion.
CONCLUSIONS: Teaching on smoking cessation in UK medical schools is inadequate.
PMID: 14985601 [PubMed - as supplied by publisher]
Sadly, the odds are that your physician's nicotine dependency recovery understanding is primarily comprised of what the NRT pharmaceutical industry want him to know. Even then it's only what the industry wants them to know.
How many know that when all over-the-counter patch and gum studies are combined and averaged that only 7% of study participants are not smoking at six months? How many physicians actually know that two different studies have now shown that the six-month smoking cessation rate for second time and subsequent nicotine patch users drops to almost 0%? How many know that 36.6% of all nicotine gum users are chronic long term users?
Imagine the number of minds and lives that could be touched if your physician's nicotine dependency understanding matched yours. There was always only one rule, no nicotine today, Never Take Another Puff!
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2. Tonnesen P, et al., Recycling with nicotine patches in smoking cessation. Addiction. 1993 Apr;88(4):533-9. Abstract - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8485431&dopt=Abstract
3. Gourlay, S.G., et al., Double blind trail of repeated treatment with transdermal nicotine for relapsed smokers, BMJ 1995;311:363-366 (5 August) http://bmj.bmjjournals.com/cgi/content/full/311/7001/363
4. Shiffman S, Hughes JR, et al., Persistent use of nicotine replacement therapy: an analysis of actual purchase patterns in a population based sample, Tobacco Control 2003 November; 12: 310-316. Abstract - http://tc.bmjjournals.com/cgi/content/abstract/12/3/310