Ask most doctors if they believe smoking is harmful to your health, and almost every one of them will answer with a resounding “Yes.” In fact, the Doctor’s Survey of more than 15,000 physicians spanning nearly a dozen nations funded by a grant from the Foundation for a Smoke-Free World (FSFW) revealed an average of 87% of health professionals were in agreement that helping patients who smoke quit ought to be a priority. But the survey also revealed some surprising misperceptions that could hinder the world’s 1 billion smokers from quitting.
The online survey was conducted by Sermo, an independent, worldwide peer-to-peer physician platform that focuses on brainstorming, creating, and implementing actionable health care solutions around the globe. Leading healthcare professionals from China, Germany, Greece, India, Indonesia, Israel, Italy, Japan, South Africa, the United Kingdom, and the United States were tapped to answer questions about smoking cessation and harm reduction practices.
Nicotine — Not the Villain Some Doctors Believe It To Be
The Doctors’ Survey showed the majority of those polled — on average 74% — continued to ascribe to disproven theories citing nicotine as a causative factor in the development of lung cancer, chronic obstructive pulmonary disease, atherosclerosis (a thickening or hardening of the arteries due to plaque buildup in the inner lining), and other smoking-related illnesses. While scientific research has provided data to the contrary, many physicians continue to rely on the same smoking-cessation protocols they’ve been steadily prescribing for years — protocols that are unfortunately based on misinformation.
“Nicotine is the chemical that makes cigarettes addictive. But it is not responsible for the harmful effects of smoking, and nicotine does not cause cancer. People have safely used nicotine replacement therapy (NRT) to stop smoking for many years,” Cancer Research UK reported.
Simply put, the implications for potential adverse repercussions based on outdated training smoking-cessation modalities and/or lack of current nicotine knowledge are staggering. It’s estimated that erroneous nicotine-related advice may be hampering the 1 billion smokers worldwide from seeking less-harmful alternatives to combustible tobacco consumption.
How Playing the Nicotine Blame Game Prevents Smokers from Quitting
Among the medical professionals who participated in the survey, while it was the generally accepted wisdom that combustion rather than nicotine was responsible for the lion’s share of negative smoking-related health consequences, on average, 74% of the physicians at least moderately agreed that nicotine could be counted a causative factor in lung, bladder and head, neck, and gastric cancer for their patients who smoke. (In the U.S., this figure was 70%, Germany tallied at 78%, Japan’s number was 85%, and China’s was 86%.) Additionally, 78% of those surveyed believed nicotine was a possible contributor to atherosclerosis, and on average, 76% held that nicotine consumption could result in COPD.
Such beliefs, when parlayed into counterproductive medical protocols, can set a dangerous precedent. However, not all the news from the survey was doom and gloom. For instance, approximately 81% of the physicians polled showed at least moderate interest in participating in further training focused on smoking cessation and tobacco harm reduction. Still, while 73% (on global average) did discuss the benefits of cutting down or quitting, as well as the potential risks of continuing with their patients who smoke, a relatively smaller number — 56% on average — recommended reducing combustible tobacco consumption. More disturbing still, less than half of those surveyed (48% on average) actively work to help patients develop viable plans to stop smoking.
Knowledge Is the Most Powerful Tool for Realizing Real Tobacco Harm Reduction
One of the biggest takeaways from the combined insights gleaned from their years of hands-on experience was the need to expand educational efforts within the medical community to arm doctors with the most accurate, up-to-date research and advanced, effective tools in the fight against smoking-related illnesses. “A significant majority of doctors across the globe mistakenly attribute the negative health consequences of smoking to nicotine, directly jeopardizing advancements made in helping smokers quit,” FSFW stated in a press release. “These results raise serious concerns about doctors’ ability to equip patients who smoke with the most accurate and effective advice on how to quit.”
And, “Only about half of the doctors (55% on average) recommend over-the-counter nicotine replacement therapy to aid patients with smoking reduction or cessation.”
Debunking the long-standing, erroneous nicotine/disease connection informing — or more rightly, misinforming — much of the smoking-cessation advice that continues to be disseminated is a crucial step in achieving the overall goal of worldwide tobacco harm reduction. “It is imperative that doctors get the proper training to learn the facts about nicotine and tobacco harm reduction options that can help their smoking patients quit,” Dr. Muhammad Ahmed, director of health and science research for the Foundation for a Smoke-Free World, explained. “With more than 7 million smokers dying annually from smoking-related diseases worldwide, many lives can be saved if doctors become more knowledgeable about the cessation tools available.”
Jed Rose, the President and CEO of Rose Research Center, an FSFW grantee based in Raleigh, North Carolina, adds: “Patients look to doctors for trusted health advice. Therefore, it is vital that doctors provide accurate, current advice to smokers about the health risks of smoking cigarettes compared to using products that deliver nicotine without combustion.” Rose Research Center specializes in tobacco dependence research, which focuses on smokers, addiction, smoking cessation, tobacco harm reduction, and the use of noncombustible tobacco products.
The FSFW Puts Out the Call for Further Scientific Study on Nicotine and Smoking
The Foundation for a Smoke-Free World is a U.S.-based nonprofit 501(c)(3) organization whose goal is to “improve global health by ending smoking in this generation.” The Foundation supports its core mission via a trio of broad categories of focus: health and science research; agricultural diversification; and industry transformation.
If the worldwide medical community hopes achieve better health outcomes for patients who smoke, their families, and the larger global community, healthcare professionals must further their education on smoking cessation and tobacco harm reduction solutions. To that end, the independent grantmaking organization has called on researchers to submit proposals to further analyze the Doctors’ Survey findings and propose initiatives to “help improve doctors’ fluency about smoking cessation and tobacco harm reduction.” Researchers interested in submitting proposals may contact support@smokefreeworld.org for specifications and details.
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