RESEARCH PAPER
Attitudes towards anti-smoking legislation and prevalence of tobacco consumption in Spanish primary healthcare personnel
 
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1
Unidad Especializada de Tabaquismo del Área Sanitaria IV del Principado de Asturias, Spain
2
Centro Salud de Serreria 2 (Valencia), Spain
3
Centro Salud La Jota, (Zaragoza), Spain
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Centro Salud Rodríguez Arias-San Fernando (Cádiz), Spain
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Centro Salud Perales del Río (Getafe-Madrid), Spain
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Centro Salud de Alcásser (Valencia), Spain
7
Centro Salud Robleda (Salamanca), Spain
8
Centro Salud de Delicias Sur (Zaragoza), Spain
9
Fundación de Atención Primaria de la CAMFiC, Spain
10
Centro Salud de Arnedo (La Rioja), Spain
11
Centro Salud Valdepasillas (Badajoz), Spain
12
Centro de salud Parte Vieja San Sebastián, Spain
13
Centro Salud de Tolosa, Tolosa (Gipuzkoa), Spain
14
Centro Salud Mendillorri. Pamplona (Navarra), Spain
15
Centro Salud de Hellin (Albacete), Spain
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Centro Salud Redondela, Redondela (Pontevedra), Spain
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Centro Salud de Coll d’en Rabassa (Palma de Mallorca), Spain
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Centro Salud Infanta Mercedes (Madrid), Spain
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Centro Salud de Vargas (Udesta), Santander, Spain
20
Centro de Salud Alfaro, (La Rioja), Spain
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Centro Salud de Barranco Grande (Tenerife), Spain
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Subdirección General de Planificación, Cuidados y Cronicidad del Sistema Murciano de Salud, Murcia, Spain
23
Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Spain
CORRESPONDING AUTHOR
Carlos Martin-Cantera   

Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Spain
Publish date: 2019-03-04
Submission date: 2018-11-08
Final revision date: 2019-01-24
Acceptance date: 2019-02-15
 
Tob. Prev. Cessation 2019;5(March):9
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Our aim was to ascertain how the anti-smoking legislation of 2005/2010 has affected the behavior of primary healthcare center (PHC) personnel (medical and nonmedical) with respect to their attitudes towards tobacco, its consumption and the legislative changes.

Methods:
The sample consisted of 2040 PHC employees (1578 women, 77.4%). Never smokers, ex-smokers, and smokers represented 46.7%, 37.8%, and 15.5% of the sample, respectively. Tobacco prevalence amongst physicians and nurses was 12.3%. Following the introduction of the antismoking legislation, a decrease in consumption was observed. Most of the participants considered that tobacco consumption affected health, was an addictive illness, and passive smoking had an impact on the health of non-smokers. Whilst 91.6% agreed with the current legislation, only 25% felt that it encouraged cessation.

Results:
The sample was made up of 2040 PHC employees (1578 women; 77.4%). Never smokers, ex-smokers, and smokers represented 46.7%, 37.8%, and 15.5%, respectively. Tobacco prevalence amongst physicians and nurses was 12.3%. Following the introduction of the anti-smoking legislation a decrease in consumption was observed. Most of the participants considered that tobacco affected health, was an addictive illness, and passive smoking had an impact on the health of non-smokers. Whilst 91.6% agreed with the current legislation, only 25% felt that it encouraged cessation.

Conclusions:
Spanish primary healthcare professionals have a relatively low prevalence of smoking compared to the general population. It is necessary to implement more legislative measures to improve and maintain this outcome.

ACKNOWLEDGEMENTS
We thank all our colleagues from the Spanish Primary Healthcare Centers for their collaboration in our study.
CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
There was no source of funding for this research.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
REFERENCES (35)
1.
World Health Organization. MPOWER: Six Policies to Reverse the Tobacco Epidemic. World Health Organization, 2008.
 
2.
Cabezas C, Advani M, Puente D, Rodriguez T, Martin-Cantera C, ISTAPS Study Group. Effectiveness of a Stepped Primary Care Smoking Cessation Intervention: Cluster Randomized Clinical Trial (ISTAPS study). Addiction. 2011;106(9):1696-1706. doi:10.1111/j.1360-0443.2011.03491.x.
 
3.
Jepson RG, Harris FM, Platt S, Tannahill C. The effectiveness of interventions to change six health behaviours: a review of reviews. BMC Public Health. 2010;10:538. doi:10.1186/1471-2458-10-538.
 
4.
Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2013;(5):CD000165. doi:10.1002/14651858.CD000165.pub4.
 
5.
Stead LF, Koilpillai P, Lancaster T. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database Syst Rev. 2015;(10):CD009670. doi:10.1002/14651858.CD009670.pub3.
 
6.
Martin-Cantera C, Puigdomenech E, Ballve JL, Arias OL, Clemente L, Casas R, et al. Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review. BMJ Open. 2015;5(10):e008807. doi:10.1136/bmjopen-2015-008807.
 
7.
Cakir B, Tas A, Sanver TM, Aslan D. Doctor's enquiry: an opportunity for promoting smoking cessation-findings from Global Adult Tobacco Surveys in Europe. Eur J Public Health. 2017;27(5):921-925. doi:10.1093/eurpub/ckx094.
 
8.
Tong EK, Strouse R, Hall J, Kovac M, Schroeder SA. National survey of U.S. health professionals' smoking prevalence, cessation practices, and beliefs. Nicotine Tob Res. 2010;12(7):724-733. doi:10.1093/ntr/ntq071.
 
9.
Perez-Rios M, Fernandez E, Schiaffino A, Nebot M, Lopez MJ. Changes in the Prevalence of Tobacco Consumption and the Profile of Spanish Smokers after a Comprehensive Smoke-Free Policy. PLoS One. 2015;10(6):e0128305. doi: 10.1371/journal.pone.0128305.
 
10.
World Health Organization. WHO report on the global tobacco epidemic, 2017: monitoring tobacco use and prevention policies; 2017.
 
11.
Smoke Free Partnership. 2016 Annual Report. Smoke Free Partnership: a world without tobacco 2016. https://smokefreepartnership eu/about-us/annual-reports/2016-annual-report 2016. Accessed November 8, 2018.
 
12.
Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ. 2002;325(7357):188. PMID:12142305.
 
13.
Hopkins DP, Razi S, Leeks KD, Priya KG, Chattopadhyay SK, Soler RE. Smokefree policies to reduce tobacco use. A systematic review. Am J Prev Med. 2010;38(2 Suppl):S275-289. doi:10.1016/j.amepre.2009.10.029.
 
14.
Frazer K, Callinan JE, McHugh J, et al. Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst Rev. 2016;2:CD005992. doi:10.1002/14651858.CD005992.pub3.
 
15.
Martinez C, Martinez-Sanchez JM, Anton L, et al. Prevalencia de consumo de tabaco en trabajadores hospitalarios: metaanálisis en 45 hospitales catalanes (Smoking prevalence in hospital workers: meta-analysis in 45 Catalan hospitals). Gac Sanit. 2016;30(1):55-58. doi:10.1016/j.gaceta.2015.08.006.
 
16.
Jimenez-Ruiz CA, Riesco Miranda JA, Ramos PA, et al. Prevalence of and Attitudes towards Smoking among Spanish Health Professionals. Respiration. 2015;90(6):474-480. doi:10.1159/000441306.
 
17.
Prochaska JO, Redding CA, Evers KE. The Transtheoretical model and stages of change. In: Glanz K, Rimer BK, Viswanath K. Health behavior and health education. Theory, research, and practice. 4th ed. San Francisco, CA: John Wiley & Sons, Inc;2008:97–122.
 
18.
Reyes Uruena JM, Buron PA, Sala SM, Serra PC, Diaconu A, Macia GF. Evolución del consumo de tabaco en trabajadores de un hospital de Cataluña (Temporal evolution of tobacco consumption among health care workers in a Catalonian hospital, Spain). Rev Esp Salud Publica. 2013;87(4):407-417. doi:10.4321/S1135-57272013000400010.
 
19.
Tenas MJ, Ballesteros A, Barcelo I, et al. Actitud de los profesionales de Atención Primaria frente al tabaco. Semergen. 2008;34(3):113-118. doi:10.1016/s1138-3593(08)71862-8
 
20.
Cerrada EC, Olmeda CL, Senande EB, Rodriguez BG, Sanz CT. Opiniones, prácticas, barreras y predisposición al cambio, a la hora de dar consejo para dejar de fumar (Views, practices, barriers, and the will to change, when counselling to give up smoking is being given). Aten Primaria. 2005;36(8):434-441. doi:10.1157/13081057.
 
21.
Fernandez Ruiz ML, Sanchez BM. (Evolution of the prevalence of smoking among female physicians and nurses in the Autonomous Community of Madrid, Spain). Gac Sanit. 2003;17(1):5-10. doi:10.1157/13043417
 
22.
Casas MR, Martin CC, Inglada FM, Roig RL, Moreno CC. Abordaje del tabaquismo entre los trabajadores de un distrito sanitario (Tackling tobacco dependency among a Health District's employees). Aten Primaria. 2002;29(4):218-222. doi:10.1016/s0212-6567(02)70547-7
 
23.
Alonso Gordo JM, Martinez Perez JA, Arribas AJ, Sanchez-Seco HP, Cuesta GM, Provencio HR. (Tobacco dependence in primary care: the opinion of professionals in the Guadalajara Health Area). Aten Primaria. 1997;19(8):412-417.
 
24.
Ravara SB, Castelo-Branco M, Aguiar P, Calheiros JM. Smoking behaviour trends among Portuguese physicians: are they role models? A conference-based survey. Public Health. 2014;128(1):105-109. doi: 10.1016/j.puhe.2013.08.015.
 
25.
Ravara SB, Castelo-Branco M, Aguiar P, Calheiros JM. Are physicians aware of their role in tobacco control? A conference-based survey in Portugal. BMC Public Health. 2014;14:979. doi:10.1186/1471-2458-14-979.
 
26.
Nobile CG, Bianco A, Biafore AD, Manuti B, Pileggi C, Pavia M. Are primary care physicians prepared to assist patients for smoking cessation? Results of a national Italian cross-sectional web survey. Prev Med. 2014;66:107-112. doi:10.1016/j.ypmed.2014.06.009.
 
27.
Sonmez CI, Aydin LY, Turker Y, et al. Comparison of smoking habits, knowledge, attitudes and tobacco control interventions between primary care physicians and nurses. Tob Induc Dis. 2015;13:37. doi:10.1186/s12971-015-0062-7.
 
28.
Juranic B, Rakosec Z, Jakab J, et al. Prevalence, habits and personal attitudes towards smoking among health care professionals. J Occup Med Toxicol. 2017;12:20. doi:10.1186/s12995-017-0166-5.
 
29.
Azuri J, Nashef S. Primary Care Physicians' Characteristics and Attitudes on Smoking Cessation. Am J Health Behav. 2016;40(5):578-584. doi:10.5993/ajhb.40.5.4
 
30.
Stamatopoulou E, Stamatiou K, Voulioti S, et al. Smoking behavior among nurses in rural Greece. Workplace Health Saf. 2014;62(4):132-134. doi:10.3928/21650799-20140305-05
 
31.
Huddlestone L, Walker GM, Hussain-Mills R, Ratschen E. Treating tobacco dependence in older adults: a survey of primary care clinicians' knowledge, attitudes, and practice. BMC Fam Pract. 2015;16:97. doi:10.1186/s12875-015-0317-7.
 
32.
Glahn A, Kyriakos CN, Radu Loghin C, et al. Tobacco control achievements and priority areas in the WHO Europe Region: A review. Tobacco Prevention & Cessation 2018;4(April 15). doi:10.18332/tpc/89925.
 
33.
Joossens L, Raw M. The tobacco control scale 2016 in Europe, 2017. https://www.tobaccocontrolscal.... Accessed November 1, 2018.
 
34.
Instituto Nacional de Estadistica: Estadistica de profesionales sanitarios colegiados 2018. http:// www ine es/. Accessed February 27, 2018.
 
35.
Attitudes of Europeans towards tobacco and electronic cigarettes. Special Eurobarometer 458. European Union;2017.
 
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