Smoking prevalence and attitudes toward smoking among Japanese physicians

Context The World Health Organization has advocated that physicians should not smoke cigarettes and surveys on this issue should be conducted among medical professionals. However, no nationally representative surveys of smoking among physicians in Japan have been reported. Objectives To estimate the nationwide prevalence of smoking and determine the attitudes toward smoking among Japanese physicians. Design, Setting, and Participants Descriptive study in which anonymous questionnaires were mailed to 4500 randomly selected physician members of the Japan Medical Association in the year 2000, which represents 63% of all Japanese physicians; 3771 (84%) respondents were included in the analysis. Main Outcome Measures Smoking prevalence among physicians, history of smoking, and attitudes toward smoking. Results The prevalence of cigarette smoking among physicians was 27.1% for men and 6.8% for women, about half the age-adjusted prevalences among the general Japanese population. Smoking prevalence was higher among male physicians in Ja pan than those in the United States (3%-10%) and the United Kingdom (4%-5%), Smoking prevalence differed by age, with the highest prevalence among male past smokers aged 70 years or older (51.8%; 95% confidence interval [CI], 47.4%-56.2%). Among male current smokers, the highest rates were for those aged 40 to 49 years (31%; 95% CI, 27.5%-34.5%); rates for female past smokers were highest among those aged 50 to 59 years (10.7%; 95% CI, 6.6%-14.8%) and for female current smokers were highest among those aged 70 years or older (8.2%; 95% CI, 4.8%-11.6%). Nonsmoking physicians had more unfavorable views toward smoking and were more active in encouraging patients not to smoke than those physicians who smoked. Conclusion Smoking cessation programs should be introduced among Japanese physicians to reduce the number of smoking physicians. Also, a continuing education program should be instituted to motivate physicians about their role in society.