title: Self-reported tobacco smoking practices among medical students and their perceptions towards training about tobacco smoking in medical curricula: A cross-sectional, questionnaire survey in Malaysia, India, Pakistan, Nepal, and Bangladesh.
abstract: BACKGROUND
  Tobacco smoking issues in developing countries are usually taught non-systematically as and when the topic arose. The World Health Organisation and Global Health Professional Student Survey (GHPSS) have suggested introducing a separate integrated tobacco module into medical school curricula. Our aim was to assess medical students' tobacco smoking habits, their practices towards patients' smoking habits and attitude towards teaching about smoking in medical schools.
  
  
  METHODS
  A cross-sectional questionnaire survey was carried out among final year undergraduate medical students in Malaysia, India, Nepal, Pakistan, and Bangladesh. An anonymous, self-administered questionnaire included items on demographic information, students' current practices about patients' tobacco smoking habits, their perception towards tobacco education in medical schools on a five point Likert scale. Questions about tobacco smoking habits were adapted from GHPSS questionnaire. An 'ever smoker' was defined as one who had smoked during lifetime, even if had tried a few puffs once or twice. 'Current smoker' was defined as those who had smoked tobacco product on one or more days in the preceding month of the survey. Descriptive statistics were calculated.
  
  
  RESULTS
  Overall response rate was 81.6% (922/1130). Median age was 22 years while 50.7% were males and 48.2% were females. The overall prevalence of 'ever smokers' and 'current smokers' was 31.7% and 13.1% respectively. A majority (> 80%) of students asked the patients about their smoking habits during clinical postings/clerkships. Only a third of them did counselling, and assessed the patients' willingness to quit. Majority of the students agreed about doctors' role in tobacco control as being role models, competence in smoking cessation methods, counseling, and the need for training about tobacco cessation in medical schools. About 50% agreed that current curriculum teaches about tobacco smoking but not systematically and should be included as a separate module. Majority of the students indicated that topics about health effects, nicotine addiction and its treatment, counselling, prevention of relapse were important or very important in training about tobacco smoking.
  
  
  CONCLUSIONS
  Medical educators should consider revising medical curricula to improve training about tobacco smoking cessation in medical schools. Our results should be supported by surveys from other medical schools in developing countries of Asia.
authors.affiliation: Department of Community Medicine, Melaka Manipal Medical College, Melaka, Malaysia. chandrashekharats@yahoo.com
authors.forename: Chandrashekhar T
authors.initials: CT
authors.lastname: Sreeramareddy
authors.forename: Sushil
authors.initials: S
authors.lastname: Suri
authors.forename: Ritesh G
authors.initials: RG
authors.lastname: Menezes
authors.forename: H N Harsha
authors.initials: HN
authors.lastname: Kumar
authors.forename: Mahbubur
authors.initials: M
authors.lastname: Rahman
authors.forename: Md R
authors.initials: MR
authors.lastname: Islam
authors.forename: Xavier V
authors.initials: XV
authors.lastname: Pereira
authors.forename: Mohsin
authors.initials: M
authors.lastname: Shah
authors.forename: Brijesh
authors.initials: B
authors.lastname: Sathian
authors.forename: Ullasa
authors.initials: U
authors.lastname: Shetty
authors.forename: Vina R
authors.initials: VR
authors.lastname: Vaswani
mesh_terms: D001211:Asia, Western / Q000453:epidemiology; D001290:Attitude; D003430:Cross-Sectional Studies; D003479:Curriculum; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D012907:Smoking / Q000453:epidemiology*; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult