Prevention and treating tobacco use: Role of physicians and medical students

The objective of this paper is to present cigarette smoking as the largest risk factor for premature death, the nature of smoking dependence, the methods for its cessation, tobacco intervention training at the medical schools, and importance of the leadership of health care providers in smoking prevention. Effective dependence treatment strategies exist at the level of the practicing physician, at the level of the health care system and at the societal or community level. The key elements of smoking intervention counseling include providing reinforcement through repeated and consistent advice from a team of practitioners to stop smoking, setting a specific quitting date, and scheduling follow-up visits. Unfortunately majority of medical schools teach tobacco intervention skills inadequately. Traditional didactic approaches that include lectures and assigned readings should be reduced in favor of the patientoriented methods. Because smoking as a risk factor is preventable, it is necessary to conduct rigorous preventive measures, including educational programs and various legal actions, such as restrictions on the purchase of tobacco products to teenagers and creation of smoke-free areas. Reduction in the prevalence of smoking among physicians and other health care professionals also significantly influences willingness of society to recognize the health consequences of smoking and perhaps lead to the decline of the smoking epidemic. Therefore, a special attempt should be made to reduce smoking among health professionals, including medical students. The medical students of Yugoslavia made an effort to promote prevention of smoking by introducing A Day Without a Cigarette which is observed on January 31st. The best way to discourage smoking is by approaching children and adolescents since most people start smoking in their teenage years. This age group must recognize the harmful effects of smoking. Banning advertising and other promotional activities of tobacco producers, as well as smoking in hospitals, work places, restaurants, and public transportation is a very strong weapon against smoking.