Tubercle and Lung Disease: Supplement 111

409 BRAZIL: A HOMOGENEOUS TOBACCO SUCCESS IN AGRICULTURE, INDUSTRY, COMMERCE, ILLNESS AND DEATH

Rigatto, M., Oliveira Netto, I. C., Kauer, C. L. R.; Universidade Federal do Rio Grande do Sul, Port0 Alegre, RS, Brasil

Brazil is the 4th largest world producer of tobacco - 6.2% of world total - back only to China, USA and India: an agricultural success of tobacco. It is the second largest world exporter of tobacco - 200,000 metric tons/year - being bound to become the first by surpassing the USA in a few years time: a commercial success of tobacco. Brazil produces 150 billion cigarettes per year which pay the largest industrial tax of the country, far above the amount paid by the car and the alcoholic beverages industries put together: an industrial success of tobacco. Brazil has the largest world number of babies - one million per year - being born handicapped by maternal smoking. Cotinine in the urine of breastfed neonates has shown a high contami- nation by maternal smoking, both via milk and via surrounding air. On the other hand, tobacco associated diseases do respond for the largest share of adult outpa- tients and hospitalized patients, with emphasis in intensive cart units: a success of tobacco as a cause of illness. Finally tobacco associated diseases are the largest cause of mortality in the country - 120,000 deaths per year; 15 % of total deaths - a success of tobacco as a tool for death. An antismoking campaign is active in the country since 1975. It did succeed to change a 4% per year increase in the consumption of cigarettes “per capita”, in the seventies, by a 1% drop per year, in the last ten years. A perspective of success in anti-tobacco campaign?

410 ITALIAN CHEST PHYSICIANS AND TOBACCO SMOKE: A SURVEY

Nardini, S. (I), Purro, A. (2), Lusuardi, M. (2), Mandro, M. (I), Dormer, C. F. (2); (I) lJSL 36Ospedale Civile di Mestre (Venice)- Chest Disease Unit, (2) Clinica de1 Lavoro Foundation, IRCCSI Medical Centre of Rehabilitation, Veruno, ItalylDivision of Pul- monary Disease

Background Many severe diseases are caused by tobacco smoke and smoking cessation is a critical issue in their prevention and treatment. Physicians are involved in counselling about smoke but the effects of their advice can be influenced by their own smoking habits. While in Italy the general population have been decreasing tobacco consumption, little is known about current smoke attiudes among physicians. In 1986 a National survey showed that almost one half of Italian doctors usually smoked, with peaks (> 50%) in surgical and obstetric wards, an overall rate higher than in general population. In this study we tried to assess the rate of current smokers among a sample of Italian Doctors.

Materials and Methods A questionnaire was distributed to Italian Physicians attending 4 recent major respiratory medicine meetings, held in Italy during one year, which asked information about age, qualifications, knowledge of smoking related disease and personal smoking habits. 150 answers were collected and analized.

Results * Mean age 45 (range: 28-67) Chest Physicians 68 % * Dangers of tobacco smoke over-

emphasized in your opinion No 86 % ; Yes 14 %

* Dangers of tobacco smoke versus air pollution More 46 % ; The same 54 %

* Smoking habits: Never smokers 62 % ; Quitters 26.5 % ; Current smokers 11.5 %

* Smoke in presence of patients Never 80% ; Sometimes 20 %

*Doctor’s life-style can influence patients Yes 86%: No 14%

Conclusion Even not as good as in other European countries (in United Kingdom the rate of chest physicians who smokes is virtually zero), Italian situation has been improving. Although our sample was biased by selection (which probably underestimated the reality), the number of smokers among chest Physicians was lower than expected, almost one third having quitted (40% during the last 5 years), with a trend already observed in the general population. Dangers of smoking tobacco are not fully aknowledged by a certain number of doctors: this can explain not only one’s personal habits but also poor consideration of patient needs when smoking in their presence, in spite of realization that doctor’s behaviour can influence people. Enough compliance to anti- tobacco coampaign can be predicted but more must be done to update physicians about risks of smoking tobacco as well as about their own role in educating patients.

411 CHANGE IN CIGARETTE-SMOKING AMONG MEDICAL STUDENTS

Kozielski, J., Jastrzebski, D., Gabrys. J.; Dept. of Pneumonology 51. Med. Academy, ul. Koziolka 1, PL 40-803 Zabrze

IN 1983, surveys were conducted among 2nd-year medical students (aged 19-22) with regard to their cigarette smoking habits. After 10 years the surveys were repeated, likewise among 2nd-year medical students. A significant decrease in smoking was found among students in the later survey - and chiefly among male students (table 1).

Tabl. 1:

In 1983 the majority of the students who smoked (72%) had started smoking prior to their university studies. 26 % of them already at elementary school. Of today’s smokers, 75% began smoking during their university studies. In 1983, 47% of the students smoked fewer than 5 cigarettes a day. Today, the figure in 64%. The corresponding figures of students smoking more than 20 cigarettes a day are 8 % and 6 % respectively. The reasons for smoking - chiefly among women students - are stress and sociability.

We conclude that the conducting of anti-smoking cam- paigns during the first year of university studies can significantly limit the spread of the smoking habit among future doctors.