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J Addict Dis. 2007;26(3):101-6.

Tobacco awareness in three U.S. medical schools.

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The Johns Hopkins University School of Medicine, Baltimore, MD, USA.



To evaluate the attitudes, knowledge, and beliefs of future physicians regarding smoking cessation and tobacco-related issues and the development of these attributes during the course of medical education.


In a cross-sectional survey, questionnaires were completed by 298 first- and fourth-year medical students at three medical schools from 2003 through 2004. The primary outcomes were knowledge of the health effects of tobacco and smoking cessation strategies, attitudes toward smoking cessation, and anticipated clinical behavior with respect to addressing smoking behavior and cessation with future patients.


Fourth-year medical students had knowledge scores that were 13% higher than first-year students for smoking-caused morbidity and mortality and understanding the physician's /role in smoking cessation. The average proportion of correct responses for specific knowledge of smoking cessation was only 64% and did not differ significantly between fourth- and first-year medical students. Three-quarters of fourth-year students felt they needed further training in counseling patients to stop smoking.


In this study, medical students had not received adequate education to provide effective and appropriate smoking cessation counseling to their patients. In general, this indicates a need for medical schools to place greater emphasis on developing the knowledge-base and skills required for future physicians to effectively guide their nicotine-dependent patients to stop smoking.

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