title: Medical school curriculum characteristics associated with intentions and frequency of tobacco dependence treatment among 3rd year U.S. medical students.
abstract: OBJECTIVE
  Physicians play a critical role in addressing tobacco dependence, yet report limited training. Tobacco dependence treatment curricula for medical students could improve performance in this area. This study identified student and medical school tobacco treatment curricula characteristics associated with intentions and use of the 5As for tobacco treatment among 3rd year U.S. medical students.
  
  
  METHODS
  Third year medical students (N=1065, 49.3% male) from 10 U.S. medical schools completed a survey in 2009-2010 assessing student characteristics, including demographics, tobacco treatment knowledge, and self-efficacy. Tobacco curricula characteristics assessed included amount and type of classroom instruction, frequency of tobacco treatment observation, instruction, and perception of preceptors as role models.
  
  
  RESULTS
  Greater tobacco treatment knowledge, self-efficacy, and curriculum-specific variables were associated with 5A intentions, while younger age, tobacco treatment self-efficacy, intentions, and each curriculum-specific variable were associated with greater 5A behaviors. When controlling for important student variables, greater frequency of receiving 5A instruction (OR=1.07; 95%CI 1.01-1.12) and perception of preceptors as excellent role models in tobacco treatment (OR=1.35; 95%CI 1.04-1.75) were significant curriculum predictors of 5A intentions. Greater 5A instruction (B=.06 (.03); p<.05) and observation of tobacco treatment (B=.35 (.02); p<.001) were significant curriculum predictors of greater 5A behaviors.
  
  
  CONCLUSIONS
  Greater exposure to tobacco treatment teaching during medical school is associated with both greater intentions to use and practice tobacco 5As. Clerkship preceptors, or those physicians who provide training to medical students, may be particularly influential when they personally model and instruct students in tobacco dependence treatment.
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: Rashelle.Hayes@umassmed.edu.
authors.forename: Rashelle B
authors.initials: RB
authors.lastname: Hayes
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Sybil L
authors.initials: SL
authors.lastname: Crawford
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Denise G
authors.initials: DG
authors.lastname: Jolicoeur
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Churchill
authors.affiliation: Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States.
authors.forename: Kolawole S
authors.initials: KS
authors.lastname: Okuyemi
authors.affiliation: Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.
authors.forename: Sean P
authors.initials: SP
authors.lastname: David
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Georgetown University Hospital, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Adams
authors.affiliation: Department of Clinical and Diagnostics Sciences/UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, United States.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Waugh
authors.affiliation: Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States.
authors.forename: Sharon S
authors.initials: SS
authors.lastname: Allen
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
authors.forename: Frank T
authors.initials: FT
authors.lastname: Leone
authors.affiliation: Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.
authors.forename: Randy
authors.initials: R
authors.lastname: Fauver
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Katherine
authors.initials: K
authors.lastname: Leung
authors.affiliation: Wistar Institute, Philadelphia, PA, United States.
authors.forename: Qin
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Judith K
authors.initials: JK
authors.lastname: Ockene
mesh_terms: D000328:Adult; D002982:Clinical Clerkship; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D020377:Self Efficacy; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000628:therapy*; D014481:United States; D055815:Young Adult
keywords: Medical school curriculum and education; Medical students; Tobacco dependence treatment