Carbon monoxide, cigarettes and family doctors

Aims and background: General practitioners could play a key role in prevent ive programs against tobacco-related diseases. However, they seldom take ac tion in the office even with minimal advice counselling. Such behaviour mig ht reflect the lack of academic teaching and the lack of practice with moti vational and dependence questionnaires, considered basic tools to help smok ers to quit successfully. The study was aimed to investigate the awareness of a sample of Italian family doctors as regards tobacco epidemiology and s moking cessation strategies. Methods: A total of 428 family doctors were administered a questionnaire wi th a set of questions on their personal smoking habits and on personal init iatives in the office towards smokers. Another set of questions regarded th eir knowledge on tobacco issues, with special attention to carbon monoxide, which is widely perceived as a very dangerous poison and works as a motiva tional tool on smokers and adolescents. Carbon monoxide measurement was car ried out on all participants to obtain objective data on smoking and to sho w the feasibility of the test. Results: The percentage of self-reported current smokers among general prac titioners was 24%, with a high prevalence of ex-smokers (46%), and 29% of n ever smokers. Family doctors were more keen to counsel adolescents than adu lts about tobacco, and they were very interested in continuing medical educ ation on the issue. The doctors who took part in our study showed a surpris ing limited knowledge of all the issues associated with smoking cessation a nd prevention such as epidemiology, cigarette characteristics, success rate of smoking cessation programs, Fagerstrom's tolerance questionnaire, safet y of nicotine replacement therapy and the knowledge of carbon monoxide as a product of cigarette smoke. Conclusions: The scenario depicted by our survey underscores the necessity to improve the knowledge and performance of primary care physicians on toba cco-related issues in order to implement primary and secondary prevention i n clinical practice.