Tabaquismo en médicos de la República Argentina II. Estudio TAMARA II;
The TAMARA II Trial. Smoking Among Physicians in Argentina

Introducción: El tabaquismo es la principal causa de morbimortalidad evitable, por lo que es importante conocer las característicasdel tabaquismo en los médicos y su actitud con los pacientes fumadores.Objetivo: Investigar la prevalencia de tabaquismo en médicos de la Argentina, los factores asociados con su consumo y laconducta frente a sus pacientes fumadores.Material y métodos: Estudio observacional y transversal de médicos de distintas especialidades de la Argentina, realizado entrejunio y diciembre de 2013. Mediante una encuesta estructurada, se analizaron factores de riesgo cardiovascular asociados, lascaracterísticas del consumo de tabaco, el entrenamiento en tabaquismo y la actitud frente al paciente fumador.Resultados: Se encuestaron 3.033 médicos, 57% varones, edad promedio 41,3 ± 12 años, con una proporción de fumadores del19,7% y de exfumadores del 21,7%. Ejercer una especialidad quirúrgica (OR 1,29) o trabajar en urgencias (OR 1,41) aumentóla probabilidad de ser fumador.El 36,6% y el 40,8% recibieron entrenamiento antitabaco en pregrado y posgrado, respectivamente. Ser joven, tener una especialidadclínica o trabajar en un medio privado se asoció con mayor adiestramiento. Aquellos con capacitación tenían mayorposibilidad de brindar siempre consejo de cesación y lo daban menos los fumadores o los que ejercían especialidades quirúrgicas.Los exfumadores presentaron una prevalencia mayor de factores de riesgo y de eventos vasculares. Estos y los fumadorestenían más antecedentes familiares de tabaquismo.Conclusiones: La prevalencia de tabaquismo en médicos argentinos es elevada. Distintos factores repercuten en la probabilidadde ser fumador, en el entrenamiento en tabaquismo o en la posibilidad de dar consejo médico. Se debe brindar mayorentrenamiento antitabaco.

Background: Smoking is the leading cause of preventable morbidity and death. It is important to know the characteristics ofsmoking habits among physicians and their attitude toward patients who smoke.Objective: The aim of this study is to investigate the prevalence of smoking among physicians in Argentina, the factors associatedwith tobacco consumption and their attitude toward patients who smoke.Methods: An observational cross- sectional study was performed between June and December 2013 in Argentine physiciansof different specialties. Using a structured survey, the following variables were analyzed: associated cardiovascular risk factors,characteristics of tobacco consumption, smoking cessation training and the attitude toward the patient who smokes.Results: 3033 physicians were surveyed; 57% were men and mean age was 41.3±12 years; 19.7% were current smokers and21.7% were former smokers. The probability of being a smoker was higher among surgeons (OR 1.29) or physicians workingat the emergency room (OR 1.41).Undergraduate and postgraduate tobacco cessation training was achieved by 36.6% and 40.8% of physicians, respectively. Youngphysicians, clinical specialties or private practice were associated with higher level of training. Tobacco cessation counselingwas more frequent in physicians with higher level of training than physicians who smoked or surgeons.Former smokers presented higher prevalence of risk factors and cardiovascular events. Family history of smoking habit wasmore common in former smokers and current smokers.Conclusions: The prevalence of smoking among Argentine physicians is high. Different factors are involved in the probabilityof smoking, tobacco cessation training or the possibility of medical counseling. Higher level of training in smoking cessationmust be provided.