title: Are physicians aware of their role in tobacco control? A conference-based survey in Portugal.
abstract: BACKGROUND
  The crucial role of physicians in tobacco control (TC) is widely recognized. In 2008, Portugal implemented a non-comprehensive smoke-free policy (SFP). In 2009, a conference-survey was carried out to explore Portuguese physicians' engagement in tobacco control, by evaluating the following: 1) attendance at TC training and awareness of training needs; 2) participation in TC activities; 3) attitudes and beliefs regarding SFPs.
  
  
  METHODS
  Questionnaire-based cross-sectional study conducted during two major national medical conferences targeting GPs, hospitalists, and students/recent graduates. Descriptive analysis and logistic regression were performed.
  
  
  RESULTS
  Response rate was 63.7% (605/950). Of the 605 participants, 58.3% were GPs, 32.4% hospitalists, 9.3% others; 62.6% were female; mean age was 39.0 ± 12.9 years. Smoking prevalence was 29.2% (95% CI: 23.3-35.1) in males; 15.8% (95% CI: 12.1-19.5) in females, p < 0.001. While the overwhelming majority of physicians strongly agreed that second-hand smoke (SHS) endangers health, awareness of SFP benefits and TC law was limited, p < 0.001. A significant minority (35.5%) believed that SHS can be eliminated by ventilation systems. Most physicians lacked training; only a minority (9.0%) participated regularly in TC. Training was the most consistent predictor of participation in TC. General agreement with SFP was high; but significantly lower for indoor leisure settings, outdoors bans in healthcare/schools settings and smoking restrictions in the home/car, p < 0.001. Smoking behaviour strongly predicted support for smoking restrictions in restaurants and bars/discos, healthcare outdoors and private settings.
  
  
  CONCLUSIONS
  The findings suggest that Portuguese physicians are not aware of their role in tobacco control. Poor engagement of physicians in TC may contribute to the current lack of comprehensive policies in Portugal and Europe and undermine social norm change. Medical and professional continuing education on tobacco control should be made top priorities.
authors.affiliation: Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Av, Infante D, Henrique, 6200-506 Covilha, Portugal. sbravara@fcsaude.ubi.pt.
authors.forename: Sofia B
authors.initials: SB
authors.lastname: Ravara
authors.forename: Miguel
authors.initials: M
authors.lastname: Castelo-Branco
authors.forename: Pedro
authors.initials: P
authors.lastname: Aguiar
authors.forename: Jose M
authors.initials: JM
authors.lastname: Calheiros
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010820:Physicians / Q000706:statistics & numerical data*; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D061845:Smoke-Free Policy; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D014026:Nicotiana
chemical_list: D014028:Tobacco Smoke Pollution