Smoking behaviour and attitudes towards smoking of medical students in Australia, Japan, USA, Russia, and Estonia

• Published in: Tobacco control 1993-03, Vol.2 (1), p.24-29
• Main Authors: Tessier, J. F., Freour, P., Nejjari, C., Belougne, D., Crofton, J. W.
• Format: Article
• Language: English
• Subjects: Anti smoking movements; Cigarette smoking; Coronary artery disease; Medical students; Nursing students; Questionnaires; Smoking cessation; Student surveys; Tobacco smoking; Urinary bladder
• ISSN: 0964-4563; 1468-3318
• DOI: 10.1136/tc.2.1.24

Objective — To assess the behaviour, knowledge and attitudes of medical students towards smoking, and to stimulate interest in the problem among students and their teachers. Design — As part of a global survey, first- and final-year students from eight centres in five industrialized countries (Australia, Japan, USA, Russia and Estonia [formerly part of the USSR]) replied anonymously to a structured questionnaire in their own teaching language. Subjects — A total of 1280 replies was analysed. Participation was 94% for first-year students, 82% for final year. The percentage of females overall was 44% but varied widely, from 12% in Tohoku, Japan, to 78% in Moscow. Results — The prevalence of daily smoking in male medical students varied from nil in the USA to 48% in St Petersburg; in females from nil in Japan to 14% in St Petersburg. Many smokers had already made serious attempts to quit; many, except in Japan, expected to have succeeded within 5 years. Most considered smoking harmful to health (with lower rates in smokers), but, even in the USA and Australia, there was important ignorance about tobacco as a major cause of certain conditions, notably cardiovascular disease, laryngeal and bladder cancer, and neonatal mortality, with some differences between countries; in Japan and the former USSR the figures were low (53% and 51%, respectively) even for lung cancer. High proportions in Australia and the USA, but much lower proportions in Japan and Estonia, would give routine advice on quitting to smoking patients, but in all countries most lacked confidence in their counselling skills. Australian and US students were most, and Japanese students least, conscious of their exemplar roles. There were similar trends between countries in support of preventive legislation. There was widespread ignorance of the preventive effect of tobacco taxation. Conclusions — Trends in smoking behaviour, and to some extent in knowledge and attitudes, reflected the history of the anti-smoking campaigns in these countries. US and Australian students had lower smoking rates than those in Japan and the former USSR. The former were more conscious of their exemplar role and more ready to counsel patients on quitting (though lacking confidence in their skill to do so); they were more aware of, and supportive of, preventive measures. There were similar trends between countries in knowledge of smoking-related diseases, but important gaps in knowledge remained even in Australian and US stud