REVIEW PAPER
The historical decline of tobacco smoking among Australian physicians: 1964–1997
Derek R Smith 1, 2  
,  
 
 
More details
Hide details
1
WorkCover New South Wales Research Centre of Excellence, School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, Australia
2
Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, Australia
Publish date: 2008-12-29
 
Tobacco Induced Diseases 2008;4(December):13
KEYWORDS
ABSTRACT
Background:
Physicians occupy an important position as tobacco control exemplars and their own smoking habits are known to influence how effective they may be in such a role.

Methods:
A comprehensive review of all published manuscripts describing tobacco usage rates and tobacco control activities in the Australian medical profession between 1964 and 1997.

Results:
Some of the earliest surveys revealed that around one-quarter of Australian physicians were smoking in the mid twentieth century, a rate which rapidly declined in the 1970s and 1980s, with reductions beyond that achieved by the general population.

Conclusions:
Overall, our review suggests that not only do contemporary Australian physicians smoke at very low rates when compared internationally, but that an active professional community can also make a real difference to the lifestyle choices of its own members.

 
REFERENCES (85)
1.
World Health Organization (WHO): Why is tobacco a public health priority?. [http://www.who.int/tobacco/hea...].
 
2.
World Health Organization (WHO): WHO framework convention on Tobacco control (WHO FCTC). [http://www.who.int/fctc/en/ind...].
 
3.
Doll R, Hill AB: The mortality of doctors in relation to their smoking habits: A preliminary report. BMJ. 1954, 1 (4877): 1451-1455.
 
4.
Doll R, Hill AB: The mortality of doctors in relation to their smoking habits: A preliminary report. 1954. BMJ. 2004, 328: 1529-1533. 10.1136/bmj.328.7455.1529.
 
5.
Doll R, Peto R, Boreham J, Sutherland I: Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004, 328: 1519-1528. 10.1136/bmj.38142.554479.AE.
 
6.
Doll R, Peto R, Boreham J, Sutherland I: Mortality from cancer in relation to smoking: 50 years observations on British doctors. Br J Cancer. 2005, 92: 426-429. 10.1038/sj.bjc.6602450.
 
7.
Stampfer M: New insights from the British doctors study. BMJ. 2004, 328: 1507-10.1136/bmj.328.7455.1507.
 
8.
Garfinkel L: Cigarette smoking among physicians and other health professionals, 1959–1972. CA Cancer J Clin. 1976, 26: 373-375. 10.3322/canjclin.26.6.373.
 
9.
Davis RM: When doctors smoke. Tob Control. 1993, 2: 187-188. 10.1136/tc.2.3.187.
 
10.
Smith D, Leggat P: An international review of tobacco smoking in the medical profession: 1974–2004. BMC Public Health. 2007, 7 (1): 115-10.1186/1471-2458-7-115.
 
11.
Gardner MN, Brandt AM: The Doctors' Choice Is America's Choice: The Physician in US Cigarette Advertisements, 1930–1953. Am J Public Health. 2006, 96: 222-232.
 
12.
Kawane H: When doctors advertised cigarettes. Tob Control. 1993, 2: 45.
 
13.
Smith DR: The historical decline of tobacco smoking among United States physicians: 1949–1984. Tob Induc Dis. 2008, 4 (1): 9-10.1186/1617-9625-4-9.
 
14.
Nishizumi M, Kuratsune M: A survey of smoking habits of physicians in Western Japan. Nippon Koshu Eisel Zasshi. 1967, 14: 1273-1294.
 
15.
Adriaanse H, van Reek J: Physicians' smoking and its exemplary effect. Scand J Prim Health Care. 1989, 7: 193-196. 10.3109/02813438909088663.
 
16.
Lee DJ, LeBlanc W, Fleming LE, Gomez-Marin O, Pitman T: Trends in US smoking rates in occupational groups: The National Health Interview Survey 1987–1994. J Occup Environ Med. 2004, 46: 538-548. 10.1097/01.jom.0000128152.01896.ae.
 
17.
Nelson DE, Emont SL, Brackbill RM, Cameron LL, Peddicord J, Fiore MC: Cigarette smoking prevalence by occupation in the United States. A comparison between 1978 to 1980 and 1987 to 1990. J Occup Med. 1994, 36: 516-525.
 
18.
Nelson DE, Giovino GA, Emont SL, Brackbill R, Cameron LL, Peddicord J: Trends in cigarette smoking among US physicians and nurses. JAMA. 1994, 271: 1273-1275. 10.1001/jama.271.16.1273.
 
19.
Kaetsu A, Fukushima T, Moriyama M, Shigematsu T: Smoking behavior and related lifestyle variables among physicians in Fukuoka, Japan: A cross sectional study. J Epidemiol. 2002, 12: 199-207.
 
20.
Chapman S, Byrne F, Carter SM: "Australia is one of the darkest markets in the world": the global importance of Australian tobacco control. Tob Control. 2003, 12 (Suppl 3): iii1-3.
 
21.
Hill DJ, White VM, Gray NJ: Measures of tobacco smoking in Australia 1974–1986 by means of a standard method. Med J Aust. 1988, 149 (1): 10-12.
 
22.
Magnus P: Cigarette smoking and the Australian medical profession. Med J Aust. 1989, 150 (8): 437.
 
23.
US National Library of Medicine: PubMed database. [http://www.ncbi.nlm.nih.gov/en...].
 
24.
Anonymous: 4,776 answer MM smoking survey. Modern Medicine of Australia. 1964, 8 (August): 1-4.
 
25.
Anonymous: 5,976 answer MM smoking survey. Modern Medicine of Australia. 1970, 17 (August): 1-4.
 
26.
Rankin DW, Gray NJ, Hill DJ, Evans DR: Attitudes and smoking habits of Australian doctors. Med J Aust. 1975, 2: 822-824.
 
27.
Dodds AM, Rankin DW, Hill DJ, Gray NJ: Attitudes and smoking habits of doctors in Victoria. Community Health Stud. 1979, 3 (1): 28-31.
 
28.
Anonymous: You're setting the pace in the fitness stakes. Medical Practice. 1983, 9 (September): 22-24.
 
29.
Nyman K: The health of general practitioners. A pilot survey. Aust Fam Physician. 1991, 20 (5): 637-641. 644–635.
 
30.
Roche AM, Parle MD, Stubbs JM, Hall W, Saunders JB: Management and treatment efficacy of drug and alcohol problems: What do doctors believe?. Addiction. 1995, 90: 1357-1366. 10.1111/j.1360-0443.1995.tb03553.x.
 
31.
Roche AM, Parle MD, Saunders JB: Managing alcohol and drug problems in general practice: A survey of trainees' knowledge, attitudes and educational requirements. Aust NZ J Public Health. 1996, 20 (4): 401-408. 10.1111/j.1467-842X.1996.tb01053.x.
 
32.
McCall L, Maher T, Piterman L: Preventive health behaviour among general practitioners in Victoria. Aust Fam Physician. 1999, 28 (8): 854-857.
 
33.
Young JM, Ward JE: Declining rates of smoking among medical practitioners. Med J Aust. 1997, 167: 232.
 
34.
Young JM, Ward JE: Implementing guidelines for smoking cessation advice in Australian general practice: opinions, current practices, readiness to change and perceived barriers. Fam Pract. 2001, 18 (1): 14-20. 10.1093/fampra/18.1.14.
 
35.
Doll R, Peto R, Wheatley K, Gray R, Sutherland I: Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ. 1994, 309: 901-911.
 
36.
Fowler G, Mant D, Fuller A, Jones L: The "Help Your Patient Stop" initiative. Evaluation of smoking prevalence and dissemination of WHO/UICC guidelines in UK general practice. Lancet. 1989, 1: 1253-1255. 10.1016/S0140-6736(89)92342-8.
 
37.
Woodward SD: Trends in cigarette consumption in Australia. Aust N Z J Med. 1984, 14 (4): 405-407.
 
38.
Gray NJ, Hill DJ: Patterns of tobacco smoking in Australia. Med J Aust. 1975, 2 (22): 819-822.
 
39.
Gray NJ, Hill DJ: Patterns of tobacco smoking in Australia. 2. Med J Aust. 1977, 2 (10): 327-328.
 
40.
Hill DJ, Gray NJ: Patterns of tobacco smoking in Australia. Med J Aust. 1982, 1 (1): 23-25.
 
41.
Hill D, Gray N: Australian patterns of tobacco smoking and related health beliefs in 1983. Community Health Stud. 1984, 8 (3): 307-316.
 
42.
Hill DJ: Australian patterns of tobacco smoking in 1986. Med J Aust. 1988, 149 (1): 6-10.
 
43.
Hill DJ, White VM, Gray NJ: Australian patterns of tobacco smoking in 1989. Med J Aust. 1991, 154 (12): 797-801.
 
44.
Australian Institute of Health and Welfare (AIHW): Statistics on drug use in Australia 2004. 2005, AIHW Report No. PHE 62, Canberra.
 
45.
Anonymous: SMOKER'S respiratory syndrome. Medical Journal of Australia. 1953, 2 (9): 343-344.
 
46.
National Health and Medical Research Council (NHMRC): Smoking and lung cancer: Report of the 53rd session of the NHMRC. 1962, Canberra.
 
47.
Rieger C: Correspondence: The A.M.A.'s policy on smoking tobacco. Med J Aust. 1967, 1967 (2 Suppl): 66.
 
48.
Australian Bureau of Statistics (ABS): Alcohol and tobacco consumption patterns, February 1977. 1978, ABS Cat No. 4312.0, Canberra.
 
49.
Margo J: The doctors who fight cancer with spray cans. The Sydney Morning Herald. 1983, 19 Feb: 32.
 
50.
Woodward S: Everything Dick Smith said (and wanted to say) is true. The Australian. 1987, 23 April : 3.
 
51.
Armstrong BK, Daube MM, Shean RE: A smoke-free Australia – our bicentenary resolution?. Med J Aust. 1988, 149 (1): 1-2.
 
52.
Australian Medical Association (AMA): AMA position statement: Tobacco smoking – 2005. [http://www.ama.com.au/node/224...].
 
53.
Royal Australian College of General Practitioners (RACGP): SNAP: Smoking, nutrition, alcohol and physical activity. [http://www.racgp.org.au/guidel...].
 
54.
The Royal Australasian College of Physicians (RACP) and The Royal Australian and New Zealand College of Psychiatrists (RANZCP): Tobacco policy: Using evidence for better outcomes. [http://www.racp.edu.au/downloa...].
 
55.
Brink SG, Gottlieb NH, McLeroy KR, Wisotzky M, Burdine JN: A community view of smoking cessation counselling in the practices of physicians and dentists. Public Health Rep. 1994, 109: 135-142.
 
56.
Hill HA, Braithwaite RL: Attitudes, beliefs, and practices regarding smoking and smoking cessation among African-American physicians and dentists. J Natl Med Assoc. 1997, 89: 745-751.
 
57.
An LC, Bernhardt TS, Bluhm J, Bland P, Center B, Ahluwalia JS: Treatment of tobacco use as a chronic medical condition: Primary care physicians' self-reported practice patterns. Prev Med. 2004, 38: 574-585. 10.1016/j.ypmed.2003.11.016.
 
58.
Misra R, Vadaparampil ST: Personal cancer prevention and screening practices among Asian Indian physicians in the United States. Cancer Detect Prev. 2004, 28: 269-276. 10.1016/j.cdp.2004.02.004.
 
59.
Kenna GA, Wood MD: The prevalence of alcohol, cigarette and illicit drug use and problems among dentists. J Am Dent Assoc. 2005, 136: 1023-1032.
 
60.
Smith DR, L'Abbate N, Lorusso A: Tobacco smoking among Italian physicians and the role of occupational medicine. Med Lav. 2008, 99 (1): 3-7. [http://www.lamedicinadellavoro...].
 
61.
Nardini S, Bertoletti R, Rastelli V, Donner CF: The influence of personal tobacco smoking on the clinical practice of Italian chest physicians. Eur Respir J. 1998, 12: 1450-1453. 10.1183/09031936.98.12061450.
 
62.
Zanetti F, Gambi A, Bergamaschi A, Gentilini F, De Luca G, Monti C: Smoking habits, exposure to passive smoking and attitudes to a non-smoking policy among hospital staff. Public Health. 1998, 112: 57-62. 10.1016/S0033-3506(98)00208-X.
 
63.
Nardini S, Bertoletti R, Rastelli V, Ravelli L, Donner CF: Personal smoking habit and attitude toward smoking among the health staff of a general hospital. Monaldi Arch Chest Dis. 1998, 53: 74-78.
 
64.
La Vecchia C, Scarpino V, Malvezzi I, Baldi G: A survey of smoking among Italian doctors. J Epidemiol Community Health. 2000, 54: 320-10.1136/jech.54.4.320a.
 
65.
Pizzo AM, Chellini E, Grazzini G, Cardone A, Badellino F: Italian general practitioners and smoking cessation strategies. Tumori. 2003, 89: 250-254.
 
66.
Kaetsu A, Fukushima T, Moriyama M, Shigematsu T: Change of the smoking behavior and related lifestyle variables among physicians in Fukuoka, Japan: A longitudinal study. J Epidemiol. 2002, 12: 208-216.
 
67.
Kawakami M, Nakamura S, Fumimoto H, Takizawa J, Baba M: Relation between smoking status of physicians and their enthusiasm to offer smoking cessation advice. Intern Med. 1997, 36: 162-165. 10.2169/internalmedicine.36.162.
 
68.
Kawane H, Soejima R: Smoking among doctors in a medical school hospital. Kawasaki Med J. 1996, 22: 211-216.
 
69.
Kawahara K, Ohida T, Osaki Y, Mochizuki Y, Minowa M, Yamaguchi N: Study of the smoking behavior of medical doctors in Fukui, Japan and their antismoking measures. J Epidemiol. 2000, 10: 157-162.
 
70.
Ohida T, Sakurai H, Mochizuki Y, Kamal AM, Takemura S, Minowa M: Smoking prevalence and attitudes toward smoking among Japanese physicians. JAMA. 2001, 285: 2643-2648. 10.1001/jama.285.20.2643.
 
71.
Hirayama T: Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan. Br Med J (Clin Res Ed). 1981, 282 (6259): 183-185.
 
72.
Ong E, Glantz SA: Hirayama's work has stood the test of time. Bull World Health Organ. 2000, 78 (7): 938-939.
 
73.
Ohida T, Kawane H, Kamal AMM, Takemura S, Sakurai H: Smoking among Japanese physicians. JAMA. 2001, 286 (8): 917-10.1001/jama.286.8.917.
 
74.
Kawane H: The prevalence of smoking among physicians in Japan. Am J Public Health. 1993, 83: 1640-10.2105/AJPH.83.11.1640.
 
75.
Smith DR, Takahashi K: Too many Japanese university students are still smoking tobacco. Tob Induc Dis. 2008, 4 (1): 10-10.1186/1617-9625-4-10.
 
76.
Kawane H: Smoking cessation: Physician responsibility and government's role. Respir Med. 1996, 90 (7): 440-10.1016/S0954-6111(96)90124-9.
 
77.
Fowler G: Educating doctors in smoking cessation. Tob Control. 1993, 2: 5-6. 10.1136/tc.2.1.5.
 
78.
Nett LM: The physician's role in smoking cessation: A present and future agenda. Chest. 1990, 97 (2 Suppl): 28S-32S. 10.1378/chest.97.2_Supplement.28S.
 
79.
Smith DR, Leggat PA: An international review of tobacco smoking among medical students. J Postgrad Med. 2007, 53 (1): 55-62.
 
80.
Smith DR, Leggat PA: An international review of tobacco smoking among dental students in 19 countries. Int Dent J. 2007, 57 (6): 452-458.
 
81.
Hill D, Borland R: Are doctors doing enough to stop their patients smoking?. Med J Aust. 1989, 150 (8): 413-414.
 
82.
Dickinson JA, Wiggers J, Leeder SR, Sanson-Fisher RW: General practitioners' detection of patients' smoking status. Med J Aust. 1989, 150 (8): 420-2, 425-426.
 
83.
Chapman S, Wong WL, Smith W: Self-exempting beliefs about smoking and health: differences between smokers and ex-smokers. Am J Public Health. 1993, 83 (2): 215-219. 10.2105/AJPH.83.2.215.
 
84.
Jones TE, Crocker H, Ruffin RE: Smoking habits and cessation programme in an Australian teaching hospital. Aust N Z J Med. 1998, 28 (4): 446-452.
 
85.
Chapman S, Carter SM: "Avoid health warnings on all tobacco products for just as long as we can": a history of Australian tobacco industry efforts to avoid, delay and dilute health warnings on cigarettes. Tob Control. 2003, 12 (Suppl 3): iii13-22.
 
 
CITATIONS (10):
1.
Trends in smoking behaviour among Estonian physicians in 1982–2014
Kersti Pärna, Mariliis Põld, Inge Ringmets
BMC Public Health
 
2.
The increase in cancer prevalence and hospital burden in Western Australia, 1992–2011
Susannah Maxwell, Peter O’Leary, Terry Slevin, Rachael Moorin
Population Health Metrics
 
3.
Declining Rates of Tobacco Use in the Japanese Medical Profession, 1965^|^ndash;2009
Derek R. Smith, Koji Wada
Journal of Epidemiology
 
4.
Are Smoking Habits Changing among Spanish Health Professionals? Results from the SUN Cohort 1999–2008
M. Ruiz-Canela, M.A. Martínez-González, C. López-del Burgo, J. De Irala, J.J. Beunza, M. Bes-Rastrollo
Tobacco Use Insights
 
5.
Physicians' role in advancing tobacco control in China
Kylie J. Lindorff, David J. Hill
Thoracic Cancer
 
6.
Physicians’ views on the role of smoking in smoking-related diseases: findings from cross-sectional studies from 1982–2014 in Estonia
Kersti Pärna, Mariliis Põld, Inge Ringmets
Tobacco Induced Diseases
 
7.
Cigarette smoking and smoking-attributable diseases among Estonian physicians: a cross-sectional study
Mait Raag, Kersti Pärna
BMC Public Health
 
8.
Tobacco smoking among doctors in mainland China: a study from Shandong province and review of the literature
Derek R Smith, Isabella Zhao, Lina Wang
Tobacco Induced Diseases
 
9.
Are physicians aware of their role in tobacco control? A conference-based survey in Portugal
Sofia B Ravara, Miguel Castelo-Branco, Pedro Aguiar, Jose M Calheiros
BMC Public Health
 
10.
Textbook of Addiction Treatment: International Perspectives
María Braquehais, Miquel Bel, María Navarro, Meritxell Heredia, Viviana Nasillo, Antonio Arteman, Jaume Padrós, Eugeni Bruguera, Miguel Casas
 
eISSN:1617-9625