Tobacco consumption among pediatric residents in Argentina. Current prevalence and trend over the past 10 years.

INTRODUCTION: Pediatricians are in a strategic position to prevent smoking. OBJECTIVES: To estimate the prevalence of smoking among pediatric residents, analyze associated factors, describe preventive actions, and assess the differences observed over the past decade. METHODS: Cross-sectional study with a self-administered, anonymous survey conducted among pediatric residents from eight Argentine hospitals. Smoking habit, associated factors, and attitude towards patients' or their parents' smoking were evaluated; results were compared to those obtained in 2002. RESULTS: Out of 448 surveyed physicians, 20.1% smoked. There were no significant differences between smokers and non-smokers in terms of gender, having children, number of on-call shifts, and having a supervisor who smokes. Having a parent who smoked was a risk factor for tobacco use only among women (OR: 1.98; 95% CI: 1.09-3.61; p = 0.01). Surveyed residents living with a couple had a lower smoking rate (OR: 0.57; 95% CI: 0.34-0.96; p = 0.03). Only 18.1% referred having an active behavior towards smoking patients, no differences were observed between smokers and non-smokers. In addition, there were no differences in smoking prevalence from 2002, but there was a higher rate of residents who advised their patients (32.4% versus 26.1%; p < 0.01) and warned them against smoking (37.7% versus 18.6%; p < 0.01), and of those who received information on this topic during their training (63.6% versus 39.8%; p < 0.01). CONCLUSIONS: Among resident pediatricians, 20.1% were smokers, with a higher prevalence among women with a father or mother who is a smoker. The rate of active behavior regarding patients or parents who smoke was very low. In spite of official policies, tobacco use in this group has not changed over the past decade, but there was an increase in the rate of those who received information during their training and of those who advised their patients of smoking risks.

Consumo de tabaco en médicos residentes de pediatría en la Argentina: Prevalencia actual y tendencia en los últimos diez años / Tobacco consumption among pediatric residents in Argentina: Current prevalence and trend over the past 10 years

Introducción. Los pediatras se encuentran en una posición estratégica para actuar en la prevención del tabaquismo. Objetivos. Estimar la prevalencia del tabaquismo en residentes de pediatría, analizar los factores asociados, describir su conducta preventiva y evaluar las diferencias en la última década. Métodos. Estudio transversal, por encuesta anónima, autoadministrada, que incluyó a residentes de pediatría de ocho hospitales de la Argentina. Se evaluaron el hábito de fumar, los factores asociados, la actitud hacia el consumo de tabaco de los pacientes o los padres, y se compararon los resultados con los de 2002. Resultados. De 448 encuestados, 20,1% fumaban. No hubo diferencias signifcativas entre fumadores y no fumadores respecto del sexo, los hijos, el número de guardias y el tener un jefe fumador. El padre fumador fue un factor de riesgo para tabaquismo solo en las mujeres (OR 1,98; IC 95% 1,09 a 3,61; p= 0,01). Los que vivían en pareja fumaban menos (OR 0,57; IC 95% 0,34 a 0,96; p= 0,03). Solo 18,1% refrieron tener una conducta activa frente al tabaquismo de los pacientes, sin diferencias entre fumadores y no fumadores. No hubo diferencia con la prevalencia del tabaquismo de 2002, pero sí mayor proporción de residentes que aconsejaban (32,4% contra 26,1%; p <0,01) y advertían a sus pacientes (37,7% contra 18,6%; p <0,01), y que recibieron información durante su formación (63,6% contra 39,8%; p <0,01). Conclusiones. El 20,1% de los médicos residentes de pediatría eran fumadores, siendo más frecuente en las mujeres con un padre fumador. La conducta activa frente al tabaquismo de los pacientes o sus padres fue muy baja. Pese a las políticas ofciales, el tabaquismo en este grupo no se ha modifcado en la última década, aunque aumentó la proporción de quienes recibieron información durante su formación, y aconsejan y advierten a los pacientes sobre sus riesgos.

Introduction. Pediatricians are in a strategic position to prevent smoking. Objectives. To estimate the prevalence of smoking among pediatric residents, analyze associated factors, describe preventive actions, and assess the differences observed over the past decade. Methods. Cross-sectional study with a self-administered, anonymous survey conducted among pediatric residents from eight Argentine hospitals. Smoking habit, associated factors, and attitude towards patients' or their parents' smoking were evaluated; results were compared to those obtained in 2002. Results. Out of 448 surveyed physicians, 20.1% smoked. There were no signifcant differences between smokers and non-smokers in terms of gender, having children, number of on-call shifts, and having a supervisor who smokes. Having a parent who smoked was a risk factor for tobacco use only among women (OR: 1.98; 95% CI: 1.09-3.61; p = 0.01). Surveyed residents living with a couple had a lower smoking rate (OR: 0.57; 95% CI: 0.34-0.96; p = 0.03). Only 18.1% referred having an active behavior towards smoking patients, no differences were observed between smokers and non-smokers. In addition, there were no differences in smoking prevalence from 2002, but there was a higher rate of residents who advised their patients (32.4% versus 26.1%; p < 0.01) and warned them against smoking (37.7% versus 18.6%; p < 0.01), and of those who received information on this topic during their training (63.6% versus 39.8%; p < 0.01). Conclusions. Among resident pediatricians, 20.1% were smokers, with a higher prevalence among women with a father or mother who is a smoker. The rate of active behavior regarding patients or parents who smoke was very low. In spite of offcial policies, tobacco use in this group has not changed over the past decade, but there was an increase in the rate of those who received information during their training and of those who advised their patients of smoking risks.

Consumo de tabaco en médicos residentes de pediatría en la Argentina: Prevalencia actual y tendencia en los últimos diez años / Tobacco consumption among pediatric residents in Argentina: Current prevalence and trend over the past 10 years

Introducción. Los pediatras se encuentran en una posición estratégica para actuar en la prevención del tabaquismo. Objetivos. Estimar la prevalencia del tabaquismo en residentes de pediatría, analizar los factores asociados, describir su conducta preventiva y evaluar las diferencias en la última década. Métodos. Estudio transversal, por encuesta anónima, autoadministrada, que incluyó a residentes de pediatría de ocho hospitales de la Argentina. Se evaluaron el hábito de fumar, los factores asociados, la actitud hacia el consumo de tabaco de los pacientes o los padres, y se compararon los resultados con los de 2002. Resultados. De 448 encuestados, 20,1% fumaban. No hubo diferencias signifcativas entre fumadores y no fumadores respecto del sexo, los hijos, el número de guardias y el tener un jefe fumador. El padre fumador fue un factor de riesgo para tabaquismo solo en las mujeres (OR 1,98; IC 95% 1,09 a 3,61; p= 0,01). Los que vivían en pareja fumaban menos (OR 0,57; IC 95% 0,34 a 0,96; p= 0,03). Solo 18,1% refrieron tener una conducta activa frente al tabaquismo de los pacientes, sin diferencias entre fumadores y no fumadores. No hubo diferencia con la prevalencia del tabaquismo de 2002, pero sí mayor proporción de residentes que aconsejaban (32,4% contra 26,1%; p <0,01) y advertían a sus pacientes (37,7% contra 18,6%; p <0,01), y que recibieron información durante su formación (63,6% contra 39,8%; p <0,01). Conclusiones. El 20,1% de los médicos residentes de pediatría eran fumadores, siendo más frecuente en las mujeres con un padre fumador. La conducta activa frente al tabaquismo de los pacientes o sus padres fue muy baja. Pese a las políticas ofciales, el tabaquismo en este grupo no se ha modifcado en la última década, aunque aumentó la proporción de quienes recibieron información durante su formación, y aconsejan y advierten a los pacientes sobre sus riesgos.(AU)

Introduction. Pediatricians are in a strategic position to prevent smoking. Objectives. To estimate the prevalence of smoking among pediatric residents, analyze associated factors, describe preventive actions, and assess the differences observed over the past decade. Methods. Cross-sectional study with a self-administered, anonymous survey conducted among pediatric residents from eight Argentine hospitals. Smoking habit, associated factors, and attitude towards patients or their parents smoking were evaluated; results were compared to those obtained in 2002. Results. Out of 448 surveyed physicians, 20.1% smoked. There were no signifcant differences between smokers and non-smokers in terms of gender, having children, number of on-call shifts, and having a supervisor who smokes. Having a parent who smoked was a risk factor for tobacco use only among women (OR: 1.98; 95% CI: 1.09-3.61; p = 0.01). Surveyed residents living with a couple had a lower smoking rate (OR: 0.57; 95% CI: 0.34-0.96; p = 0.03). Only 18.1% referred having an active behavior towards smoking patients, no differences were observed between smokers and non-smokers. In addition, there were no differences in smoking prevalence from 2002, but there was a higher rate of residents who advised their patients (32.4% versus 26.1%; p < 0.01) and warned them against smoking (37.7% versus 18.6%; p < 0.01), and of those who received information on this topic during their training (63.6% versus 39.8%; p < 0.01). Conclusions. Among resident pediatricians, 20.1% were smokers, with a higher prevalence among women with a father or mother who is a smoker. The rate of active behavior regarding patients or parents who smoke was very low. In spite of offcial policies, tobacco use in this group has not changed over the past decade, but there was an increase in the rate of those who received information during their training and of those who advised their patients of smoking risks.(AU)

Tobacco consumption among pediatric residents in Argentina. Current prevalence and trend over the past 10 years. / Tobacco consumption among pediatric residents in Argentina. Current prevalence and trend over the past 10 years.

INTRODUCTION: Pediatricians are in a strategic position to prevent smoking. OBJECTIVES: To estimate the prevalence of smoking among pediatric residents, analyze associated factors, describe preventive actions, and assess the differences observed over the past decade. METHODS: Cross-sectional study with a self-administered, anonymous survey conducted among pediatric residents from eight Argentine hospitals. Smoking habit, associated factors, and attitude towards patients or their parents smoking were evaluated; results were compared to those obtained in 2002. RESULTS: Out of 448 surveyed physicians, 20.1

smoked. There were no significant differences between smokers and non-smokers in terms of gender, having children, number of on-call shifts, and having a supervisor who smokes. Having a parent who smoked was a risk factor for tobacco use only among women (OR: 1.98; 95

CI: 1.09-3.61; p = 0.01). Surveyed residents living with a couple had a lower smoking rate (OR: 0.57; 95

CI: 0.34-0.96; p = 0.03). Only 18.1

referred having an active behavior towards smoking patients, no differences were observed between smokers and non-smokers. In addition, there were no differences in smoking prevalence from 2002, but there was a higher rate of residents who advised their patients (32.4

versus 26.1

; p < 0.01) and warned them against smoking (37.7

versus 18.6

; p < 0.01), and of those who received information on this topic during their training (63.6

versus 39.8

; p < 0.01). CONCLUSIONS: Among resident pediatricians, 20.1

were smokers, with a higher prevalence among women with a father or mother who is a smoker. The rate of active behavior regarding patients or parents who smoke was very low. In spite of official policies, tobacco use in this group has not changed over the past decade, but there was an increase in the rate of those who received information during their training and of those who advised their patients of smoking risks.

[Prevalence of tobacco use among pediatric residents in Argentina]. / Prevalencia del consumo de tabaco en médicos residentes de pediatría en Argentina.

OBJECTIVES: To determine the prevalence of smoking among pediatric residents in Argentina, to evaluate the risk factors associated with that habit, and to analyze the attitudes of these professionals with regard to tobacco use by their patients. METHODS: A cross-sectional study was conducted using anonymous self-administered questionnaire surveys. The surveys were used in May 2002 with pediatric residents in eight hospitals in five provinces of Argentina: Buenos Aires, Córdoba, La Plata, Mendoza, and Neuquen. The study variables were: sex, age, the year of residence, the number of times per week on night duty, if the resident's mother or father smoked, the age at which began to smoke, the place and the hospital activities in which most often smoked, if the immediate supervisor was a smoker, if had increased tobacco use after becoming a resident, attitude toward tobacco use by patients and their parents, and knowledge concerning the risks of smoking. We calculated the frequencies of the studied variables and the odds ratios (ORs) and their 95% confidence intervals (CIs). Multiple logistic regression was used in a model with all the possible predictive variables. The level of significance was P < 0.05. RESULTS: A total of 349 responses were obtained (98.8% of the residents present at the time of the survey). The prevalence of smokers among the surveyed pediatric residents was 22.2%. Among the smokers, 38.9% of them said they smoked more since becoming a resident, and 63.9% of them said that night duty was the hospital activity in which they most often smoked. After adjusting for the other variables, the remaining risk factors for smoking were having a mother who smoked (OR: 2.7; 95% CI: 1.57 to 4.84) and living alone (OR: 3.15; 95% CI: 1.58 to 6.26). Out of all the residents (both smokers and nonsmokers), only 26.5% of them said that they explained to their patients the risks of tobacco use, and only 23.2% of them suggested quitting smoking or not beginning; there were no statistically significant differences between the smoker residents and the nonsmoker residents. CONCLUSIONS: The prevalence of smoking among the pediatric residents is high and is close to the level found in other Argentine physicians. The factors associated with smoking were having a mother who smoked and living alone. The residents should take a more active role with patients or relatives of patients who smoke. Activities need to be put into place that improve the level of training on this subject in medical school and during residency.

Prevalencia del consumo de tabaco en médicos residentes de pediatría en Argentina / Prevalence of tobacco use among pediatric residents in Argentina

OBJETIVOS: Determinar la prevalencia de tabaquismo en residentes de pediatría en Argentina, evaluar los factores de riesgo asociados con ese hábito y analizar la actitud preventiva de estos profesionales en relación con el consumo de tabaco por parte de sus pacientes. MÉTODOS: Se realizó un estudio transversal por encuesta mediante cuestionarios anónimos autoadministrados. Las encuestas se aplicaron en mayo de 2002 a residentes de pediatría de ocho hospitales de las provincias de Buenos Aires, Córdoba, La Plata, Mendoza y Neuquén, en la República Argentina. Las variables de estudio fueron: el sexo, la edad, el año de la residencia en curso, el número de guardias por semana, si vivía solo, si la madre o el padre fumaban, la edad en que comenzó a fumar, el lugar y las actividades del hospital en las que más fumaba, si su jefe inmediato era fumador, si había aumentado el consumo de tabaco después de ingresar a la residencia, su actitud preventiva en relación con el consumo de tabaco por parte de sus pacientes y de los padres de sus pacientes, y sus conocimientos acerca de los riesgos del tabaquismo. Se calcularon las frecuencias de las variables estudiadas y las razones de posibilidades (odds ratios,RP) y sus intervalos de confianza de 95 por ciento (IC95 por ciento). Se aplicó la regresión logística múltiple en un modelo con todas las variables predictoras posibles. El nivel de significación fue de P <0,05. RESULTADOS: Se obtuvieron 349 respuestas (98,8 por ciento de los residentes presentes en el momento de la encuesta). La prevalencia de fumadores entre los residentes de pediatría encuestados fue de 22,2 por ciento. De ellos, 38,9 por ciento admitieron fumar más que antes de incorporarse a la residencia y 63,9 por ciento identificaron a la guardia como la actividad en la que más fumaban dentro del hospital. Después de hacer ajustes en función del resto de las variables, tanto el tener madre fumadora (RP: 2,7; IC95 por ciento: 1,57 a 4,84) como el vivir solo (RP: 3,15; IC95 por ciento: 1,58 a 6,26) siguieron siendo factores de riesgo de ser fumador. Solo 26,5 por ciento respondieron que explicaban a sus pacientes los riesgos del consumo de tabaco y 23,2 por ciento que les aconsejaban que dejaran de fumar o no comenzaran, sin diferencias entre los residentes fumadores y los que no fumaban. CONCLUSIONES: La prevalencia del tabaquismo entre los médicos residentes de pediatría es elevada, aunque se asemeja a la observada en otros médicos argentinos...