University study of smoking cessation content in medical curricula draws attention
Medical schools are not doing an adequate job of teaching medical students about the dangers of smoking and techniques to help their future patients quit, says an article in the September 1, 1999, issue of The Journal of the American Medical Association. In fact, 31 percent of schools offered less than one hour of tobacco education per year.
The article, written by Linda Ferry, MD, MPH, director of LLU's preventive medicine residency program, and two of her colleagues received national attention by the news media when the story broke. More than 70 television stations across the nation mentioned the study during news programs. The story was also carried on Associated Press and Reuter's newswires.
In the study, based on a senior research project by Pamela Sieler Runfola, MD, MPH, a graduate of the LLU preventive medicine program, the associate deans of all 126 U.S. medical schools were asked to appraise the content and extent of their curriculum on tobacco, its health effects, and intervention skills. Ultimately, 98 percent of the medical schools responded to the survey.
The authors, which also included Linda M. Grissino, MD, MPH, another LLU preventive medicine residency graduate, found that "a majority of medical students are not adequately trained to treat nicotine dependency, the most deadly preventable health-care problem in the United States."
According to national statistics, tobacco dependency is the number one cause of premature death, killing 430,000 people each year and disabling countless others.
"The major deficit is the lack of smoking cessation instruction and evaluation in the clinical years," the authors continue. "Model core tobacco curricula that meet national recommendations should be developed and implemented in U.S. medical schools."
The survey results did not surprise Dr. Ferry. Most medical schools teach their students that tobacco use is a risk factor or cause for many chronic diseases and cancer. They often cover the effects of passive smoking, the contents of tobacco smoke, the symptoms of nicotine withdrawal, and which smokers tend to have the most difficulty quitting.
What is often lacking is the use of effective teaching techniques during the clinical years to ensure that every student has the necessary skills to assist a smoker in the process of quitting.
Seven out of 10 schools did not require clinical training in smoking cessation for their students. Less than five percent of the medical schools had any measure of the student's performance following smoking cessation lectures.
"The chain of events leading up to the publicity we received is providential
in my opinion," Dr. Ferry expresses. "The timing couldn't have been better to
bring tobacco education and prevention to the attention of the nation, and what
better place for this study to be centered than at Loma Linda?"