A
report
is
presented
on
the
smoking
habits
of
the
medical
profession
in
the
Irish
Republic
based
on
a
questionnaire
study.
Findings
are
compared
with
the
general
population
and
with
those
of
doctors
in
the
United
Kingdom.
Smoking
Habits
of
the
Medical
Profession
in
the
Republic
of
Ireland
I
ntroduction
The
smoking
habits
of
the
medical
profession
have
been
studied
in
various
parts
of
the
world.
Doll
and
Hill"
2
determined
the
smoking
pattern
of
doctors
resident
in
the
United
Kingdom.
The
mortality
of
these
doctors
in
relation
to
smoking
habit
was
ascertained
ten
years
later3
and
pro-
vided
unique
evidence
of
the
benefits
to
be
derived
from
abandoning
smoking,
particularly
cigarette
smoking.
Snegireff
and
Lombard4
enquired
into
the
snioking
habits
of
physicians
in
Massachusetts
and
a
five-year
follow-up
study5
indicated
that
the
proportion
of
physicians
who
did
not
smoke
had
increased
from
34.1%
to
44.5%.
The
smok-
ing
practice
of
doctors
in
New
Zealand
was
examined
by
Gardiner
and
Taylor6
who
showed
that
60.7%
did
not
smoke
and
they
compared
smoking
habits
of
the
medical
profession
in
New
Zealand
with
those
of
Massachusetts
and
the
United
Kingdom.
It
was
decided
to
study
the
smoking
habits
of
the
medical
profession
in
the
Republic
of
Ireland
and
attitudes
to
various
aspects
of
smoking.
It
would
be
of
value
for
the
purpose
of
health
education
if
it
could
be
shown
that
doc-
tors
as
a
group
are
abandoning
smoking,
especially
cigarette
smoking,
or
are
smoking
less
than
the
general
population.
A
doctor
can
influence
his
patients
profoundly
when
it
comes
to
decisions
affecting
health.
The
doctor
who
smokes
will
inevitably
lessen
the
effect
of
any
campaign
of
public
edu-
cation
concerning
the
consequences
of
the
habit
and
will
find
it
more
difficult
to
help
patients
who
need
to
stop
smoking.7
Study
Population
and
Method
A
questionnaire
together
with
an
explanatory
let-
ter,
signed
by
one
of
us
(GJB),
and
a
post-paid
addressed
envelope
was
enclosed
in
each
of
the
2,552
copies
of
the
November
1967
issue
of
the
Irish
Medical
Times,
which
is
a
medical
newspaper
sent
without
charge
to
every
doctor
in
this
country.
Replies
were
fairly
constant
over
the
following
months
and
had
virtually
ceased
by
June
1,
1968.
At
this
time
932
(36.57O)
questionnaires
had
been
returned.
On
June
22,
1968
a
further
questionnaire
together
with
a
signed
(GJB)
explanatory
letter
and
post-paid
addressed
en-
velope
was
sent
directly
to
non-respondents,
and
by
May
1,
1969
all
replies
had
ceased.
The
second
letter
had
elicited
a
further
705
questionnaires.
A
total
of
1,637
(64.1%)
ques-
tionnaires
had
now
been
received
but
57
(2.2%o)
were
not
included
in
the
study
since
they
either
belonged
to
doctors
who
had
retired,
or
had
been
returned
by
a
relative
of
a
Geoffrey
J.
Bourke,
M.A.,
M.D.,
D.P.H.,
D.l.H.;
Keith
Wilson-Davis,
B.A.
(Econ.)
M.B.C.S.,
D.S.A.;
and
R.
Douglas
Thornes,
M.D.,
Ph.D.
doctor
who
had
died.
They
also
included
five
blank
ques-
tionnaires
two
of
which
were
accompanied
by
letters
con-
demning
such
investigations.
This
now
meant
that
1,580
(61.9%o)
completed
questionnaires
were
available
for
analysis.
It
was
decided
at
this
stage
to
compare
the
age,
sex,
and
specialty
of
the
doctors
who
returned
questionnaires
with
these
same
attributes
in
the
known
structure
of
the
profession
in
this
country.8
When
this
was
done
it
was
found
that
the
sample
of
1,580
was
representative
of
the
profession
as
a
whole
for
age
(mean
age
of
sample:
48.27
years;
mean
age
of
profes-
sion:
47.81
years;
P
>
0.05),
sex
(X2
=
0.089,
d.f.
=1,
0.70
>
P
>
0.60),
and
specialty
(males
x2
=
16.108,
d.f.
=
13,
0.30
>
P
>
0.20;
females:
x2
=
4.838,
d.f.
=
7,
0.70
>
P
>
0.60).
Doll
and
Hill3
had
found
that
non-
respondents
were
more
likely
to
be
heavier
cigarette
smok-
ers
than
respondents,
and
more
recently9
a
higher
propor-
tion
of
cigarette
smokers
among
non-respondents
has
been
reported,
so
in
this
study
an
intensive
follow-up
of
a
1
in
3
random
sample
of
the
915
non-respondents
was
under-
taken.
Of
the
305
persons
in
the
sample,
285
questionnaires
(93.4%)
were
completed.
The
results
of
this
non-respondent
sample
did
not
differ
significantly
from
the
main
sample
for
age,
sex,
specialty,
and
smoking
habit
and
will
be
the
sub-
ject
of
a
further
paper.
The
remaining
twenty
question-
naires
related
to
doctors
who
had
retired
(2),
had
died
(4),
were
unknown
at
the
address
given
(10),
while
one
doctor
was
suffering
from
a
long-term
illness
in
hospital.
Three
doctors
refused
to
give
the
required
information.
A
pre-coded
questionnaire
was
used.
In
addition
to
name,
address,
sex,
specialty,*
and
age,
questions
were
asked
to
determine
if
respondents
were
currently
smokers
of
tobacco;
had
previously
smoked
but
had
given
up;
or
had
never
smoked
regularly.
A
smoker
was
defined
as
a
person
who
on
average
smoked
as
much
as
one
cigarette
a
day,
¼4
ounce
of
tobacco
a
week,
or
two
cigars
a
week.
*If
more
than
one
specialty,
respondent
was
invited
to
indicate
the
one
which
took
up
the
greater
proportion
of
time;
if
a
choice
of
specialty
had
not
yet
been
made
the
respondent
was
asked
to
in-
dicate
the
specialty
which
it
was
intended
to
pursue.
SMOKING
HABITS
IN
IRELAND
575
Table
1-Smoking
Habit
by
Age
and
Sex
of
Medical
Profession
and
General
Population
Age
in
Years
Smoking
Sample
Population
Sample
Population
Sample
Population
Sample
Population
Sex
habit
25-34
%
%
35-59
%
%
60+
%
%
Total
%
%
Smoke
now
49
40.8
60.2
505
50.1
67.9
105
45.3
73.0
659
48.5
67.6
Used
to
Male
smoke
32
26.7
8.8
325
32.3
14.3
99
42.7
13.0
456
33.6
12.7
Never
smoked
39
32.5
31.0
177
17.6
17.8
28
12.0
14.0
244
17.9
19.7
Total
120
100.0
100.0
1,007
100.0
100.0
232
100.0
100.0
1,359
100.0
100.0
Smoke
now
6
25.0
43.0
44
26.2
45.4
9
31.0
25.0
59
26.7
38.6
Used
to
Female
smoke
2
8.3
4.3
35
20.8
8.6
12
41.4
6.0
49
22.2
7.5
Never
smoked
16
66.7
52.7
89
53.0
46.0
8
27.6
69.0
113
51.1
53.9
Total
24
100.0
100.0
168
100.0
100.0
29
100.0
100.0
221
100.0
100.0
Smokers
were
asked
the
amount
smoked
and
the
type
of
smoking
at
time
of
reply.
Ex-smokers
were
asked
when
they
ceased
to
smoke.
Further,
enquiry
was
made
as
to
whether
or
not
authoritative
or
professional
opinion
re-
garding
the
relationship
between
smoking
and
health,
was
responsible
for
the
respondent
stopping,
reducing,
or
chang-
ing
to
another
form
of
smoking.
Those
who
replied
in
the
affirmative
to
this
latter
question
were
asked
to
indicate
the
action
taken
and
the
one
health
effect
which
concerned
them
most.
Each
doctor
was
asked
if
he/she
personally
con-
sidered
smoking
injurious
to
health
and
if
applicable
to
specialty
if
he/she
advised
all
patients,
only
those
with
cer-
tain
conditions,
or
if
advice
was
not
given,
to
avoid
smoking
cigarettes.
If
advice
was
offered
only
to
patients
with
cer-
tain
conditions
respondents
were
asked
to
state
these
condi-
tions.
Results
Smoking
Habit
of
Profession
and
General
Population
In
Table
1
the
smoking
habits
of
the
medical
pro-
fession
and
the
general
population10
by
age
and
sex
are
demonstrated.
In
each
age
group
with
the
exception
of
the
60
years
and
over
females,
there
is
a
higher
proportion
of
smokers
among
the
general
population
than
among
the
medical
profession.
Among
male
doctors
48.5%
now
smoke
as
compared
with
67.6%
of
men
in
the
population
(P
<
0.001)
and
26.7%
of
female
doctors
are
current
smokers
as
compared
with
38.6%
of
the
female
population
(P
<
0.001).
It
must
be
mentioned,
however,
that
the
definition
of
smoking
for
the
general
population
(i.e.,
smoker
of
ciga-
rettes
or
pipe
by
self-definition
or
at
least
one
cigar
of
any
size
a
week)
probably
inflates
the
current
smoking
habits
and
may
contribute
to
some
extent
to
the
higher
propor-
tion
of
men
and
women
in
the
population
who
smoke
as
compared
with
the
sexes
in
the
doctor
population.
It
will
be
seen
(Table
2)
that
among
male
doctors
a
considerably
lower
proportion
(44.3%o)
smoke
cigarettes
only,
as
com-
pared
with
men
in
the
general
population
(69.3%);
there
are
more
mixed
smokers
(cigarettes
and
other;
pipe
and
cigars)
and
cigar
only
smokers
among
male
doctors,
while
pipe
smoking
is
virtually
identical
in
the
two
populations.
It
is
clear
then
that
the
reason
there
is
a
higher
proportion
of
smokers
in
the
general
male
population
is
due
to
a
higher
proportion
in
this
population
smoking
cigarettes.
Similarly
the
reason
why
there
is
a
higher
proportion
of
female
smok-
ers
in
the
general
female
population
is
due
to
an
excess
of
cigarette
smokers
in
this
population.
It
was
then
necessary
to
examine
more
closely
the
difference
in
definition
of
ciga-
rette
smoking
before
concluding
that
the
proportions
were
in
fact
significantly
different.
Data
from
the
general
popula-
tion
indicate
that
3.3%
of
males
were
placed
in
a
cigarette-
smoking
category
of
0-2
cigarettes
a
day,
so
a
proportion
of
males
in
this
category
may
be
smoking
less
than
the
study
definition
of
a
smoker.
If,
however,
it
were
assumed
that
half
the
males
in
the
general
population
in
this
category
smoked
less
on
average
than
one
cigarette
a
day
a
signifi-
cant
difference
remains
(P
<
0.005):
A
similar
examination
of
the
female
data
does
not
affect
the
significant
result
either
(P
<
0.01).
Hence,
it
was
concluded
that
the
differ-
ence
in
definition
of
cigarette
smoking
did
not
influence
the
significant
result.
When
the
ex-smoker
category
is
examined
(Table
1)
it
is
seen
that
for
each
age
group
for
both
sexes
a
greater
proportion
of
doctors
have
relinquished
the
smoking
habit.
12.7%
of
the
male
and
7.5%
of
the
female
general
popula-
tion
have
abandoned
the
smoking
habit
as
compared
with
respective
percentages
for
male
and
female
doctors
of
33.6%
(P
<
0.005)
and
22.2%
(P
<
0.001).
Separate
analy-
sis
indicates
that
cessation
of
smoking
among
the
medical
profession
has
been
very
constant
over
the
years;
there
is
no
evidence
to
indicate
the
appearance
of
higher
proportions
576
A.J.P.H.
APRIL,
1972
Table
2-Current
Smoking
Habit
by
Age
and
Sex
of
Medical
Profession
and
General
Population
Ag
in
Years
Smoking
Sample
Population
Sample
Population
Sample
Population
Sample
Population
Sex
habit
25-34
%
%
35-59
%
9
60+
%
%
Total
%
%
Cigarettes
ON
LY
27
55.1
85.5
213
42.2
73.3
52
49.6
50.6
292
44.3
69.3
Cigarettes
and
other
5
10.2
8.8
79
15.6
15.0
27
25.7
16.5
111
16.8
14.0
Male
Pipe
ONLY
8
16.3
4.4
73
14.5
8.9
12
11.4
32.4
93
14.1
14.8
Cigars
ONLY
4
8.2
1.3
101
20.0
1.5
10
9.5
0.5
115
17.5
1.3
Pipe
and
Cigars
5
10.2
0.0
39
7.7
1.3
4
3.8
0.0
48
7.3
0.6
Total
49
100.0
100.0
505
100.0
100.0
105
100.0
100.0
659
100.0
100.0
Cigarettes
ONLY
6
100.0
100.0
37
84.1
99.0
9
100.0
100.0
52
88.1
99.4
Cigarettes
Female
and
other
0
0.0
0.0
1
2.3
0.5
0
0.0
0.0
1
1.7
0.3
Cigars
ONLY
0
0.0
0.0
6
13.6
0.5
0
0.0
0.0
6
10.2
0.3
Total
6
100.0
100.0
44
100.0
100.0
9
100.0
100.0
59
100.0
100.0
of
ex-smokers
after
the
publication
of
the
two
reports
on
smoking
and
health.7'
1
In
the
never
smoked
group
at
each
age
among
males,
with
the
exception
of
those
in
the
25-34
year
group,
a
higher
proportion
of
the
general
population
had
never
smoked.
In
the
general
population
19.7%
of
men
and
in
the
medical
profession
17.9%
of
male
doctors
had
never
smoked
(P
<
0.005).
Among
females
a
higher
proportion
of
doctors
in
the
two
age
groups
below
sixty
years
had
never
smoked
while
in
the
sixty
years
of
age
and
over
group
a
higher
proportion
of
the
general
population
had
never
smoked.
In
the
female
populations
the
differences
in
the
proportions
between
the
two
never
smoked
categories
is
not
significant
(P
<
0.20).
Current
Smoking
Habit
of
Doctors
and
Specialty
As
previously
noted,
48.5%
of
all
male
doctors
smoke.
When
the
smoking
habits
of
the
different
specialties
within
the
male
medical
profession
are
examined
only
two
significant
results
arise.
A
smaller
proportion
of
doctors
who
are
specialists
in
Medicine
currently
smoke
as
com-
pared
with
the
population
of
doctors
as
a
whole
(P
<
0.001)
and
a
higher
proportion
of
general
practitioners
cur-
rently
smoke
(P
<
0.05).
Data
for
women
doctors
were
too
small
for
meaningful
analysis
by
specialty.
Table
3-Current
Cigarette
Smoking
(Average
daily
Population
Current
Smokers:
Type
of
Smoking
Habit
of
Medical
Pro-
fession
and
General
Population
The
type
of
smoking
habit
among
current
smokers
is
shown
in
Table
2.
The
trend
among
both
sexes
is
for
a
smaller
proportion
of
doctors
to
smoke
cigarettes
only,
and
with
the
exception
of
pipe
smoking
(males),
forms
of
smok-
ing
other
than
cigarette
only
smoking
are
more
common
among
the
medical
profession.
Nearly
'70.0%
of
men
in
the
general
population
smoke
cigarettes
only
as
compared
with
44.3%
of
the
male
medicai
profession
(P
<
0.001);
also
a
higher
proportion
of
women
in
the
general
population
smoke
cigarettes
only
as
compared
with
women
doctors
(P
<
0.001).
The
percentage
of
pipe
smokers
in
the
two
male
populations
is
almost
identical.
A
higher
proportion
of
male
doctors
smoke
cigarettes
and
other
tobacco
(P
<
0.01)
and
cigars
only
(P
<
0.001)
and
pipe
and
cigars
(P
<
0.001).
The
female
doctor
percentages
for
mixed
cigarette
smoking
differ
significantly
from
the
female
general
population
in
this
category
(P
<
0.001)
as
does
cigar
only
smoking
(P
<
0.001).
Current
Smokers:
Average
Daily
Cigarette
Consumption
of
Medical
Profession
and
General
Population
The
average
daily
cigarette
consumption
for
cur-
rent
smokers
is
shown
in
Table
3.
Males
in
the
general
consumption)
of
Medical
Profession
and
General
SMOKING
HABITS
IN
IRELAND
577
Males
Medical
profession
18.3
General
population
20.3
P<0.001
Females
Medical
profession
18.2
General
population
14.0
P<0.001
P>0.90
P<0.001
population
smoke
a
significantly
greater
number
of
ciga-
rettes
than
male
doctors
(P
<
0.001),
while
female
doctors
smoke
more
than
women
in
the
general
population
(P
<
0.001).
Again,
the
average
number
of
cigarettes
smoked
daily
is
very
similar
for
doctors
of
both
sexes
(P
>
0.90)
but
males
in
the
general
population
smoke
a
greater
number
of
cigarettes
daily
than
women
in
this
population
(P
<
0.001).
Separate
analysis
indicates
that
male
doctors
in
the
age
group
35-59
smoke
significantly
more
(P
<
0.001)
ciga-
rettes
daily
(20.5)
than
the
average
for
all
male
doctors
(18.3),
and
doctors
60
years
of
age
and
over
smoke
less
(P
<
0.001)
than
the
male
doctor
average.
Among
female
doc-
tors
the
variations
between
age
are
not
significant
except
for
the
60
years
and
over
category;
doctors
in
this
age
category
smoke
more
(22.3;
P
<
0.05)
than
the
female
doctor
average
(18.2).
Doctors'
Smoking
Habit:
Influence
of
Authoritative
and
Professional
Opinion
As
one
might
expect
a
higher
proportion
(71.9%o)
of
male
current
smokers
were
uninfluenced
by
authoritative
opinion
regarding
the
relationship
between
smoking
and
health
as
compared
with
ex-smokers
(50.2%)
of
the
same
sex
(X2
=
54.485,
d.f.
=
1,
P
<
0.001);
among
women,
however,
no
such
difference
was
found
(X2
=
2.874,
d.f.=
1,
0.10
>P>
0.05).
Of
the
185
(28.1%o)
male
current
smokers
who
were
influenced
158
(85.4%o)
reduced
their
quantity,
22
(11
.9%7o)
stopped
temporarily,
and
5
(2.7%o)
changed
their
habit
(2
changed
from
plain
cigarettes
to
filter
tips;
1
from
cigarettes
to
pipe;
1
from
cigars
to
pipe;
1
from
pipe
to
cigars).
Ninety
per
cent
approximately
of
those
who
smoked
cigarettes
reduced
their
quantity
as
compared
with
around
50.0%
of
smokers
of
tobacco
other
than
cigarettes.
Of
the
female
current
smokers
who
were
influenced,
all
14
were
cigarette
smokers
and
they
reduced
the
quantity
they
had
been
smoking.
Current
and
ex-smokers
who
were
influenced
by
professional
and
authoritative
opinion
were
concerned
chiefly
about
three
conditions,
cancer
of
the
lung,
chronic
bronchitis,
and
coronary
heart
disease.
There
was
small
vari-
ation
between
the
type
of
smoking
habit
and
concern
re-
garding
health
effect
in
both
sexes.
Other
health
effects
mentioned
included
cancer
of
the
upper
respiratory
and
digestive
tracts,
pulmonary
tuberculosis,
and
peptic
ulcer.
Smoking
and
Injury
to
Health
Approximately
96.0%
of
doctors
are
of
the
opin-
ion
that
smoking
is
injurious
to
health.
Current
and
ex-
smokers
of
both
sexes
are
agreed
about
this.
There
is
little
difference
in
the
proportion
regarding
smoking
as
injurious
to
health
when
looked
at
by
age
group
or
by
type
of
smok-
ing
habit.
Patients
and
Cigarette
Smoking
In
Table
4
is
shown
the
action
taken
by
doctors
with
regard
to
cigarette
smoking
and
their
patients.
There
is
Table
4-Advice
to
Patients
to
Avoid
Smoking
Cigarettes
All
Certain
Do
not
patients
%
patients
%
advise
%
Total
%
Smoke
now
226
37.9
315
52.8
56
9.3
597*100.0
Used
to
smoke
199
51.7
149
38.7
37
9.6
385t
100.0
Never
smoked
203
56.9
124
34.7
30
8.4
357
100.0
Total
628
46.9
588
43.9
123
9.2
1339
100.0
*121
did
not
reply
or
not
relevant
to
specialty
t120
did
not
reply
or
not
relevant
to
specialty
Table
5-Smoking
Habits
of
Medical
Profession
(Male)
in
United
Kingdom
(1966)
and
Republic
of
Ireland
1968-69
Republic
of
Ireland
United
Kingdom
Smoking
habit
1968469
1966*
Males
%
Males
%
Smoke
now
Cigarettes
only
21.5
21.1
Cigarettes
&
other
8.2
8.7
Pipe
only;
cigars
only
Cigars
&
pipe
18.8
18.9
48.5
48.7
Used
to
smoke
33.6
33.6
Never
smoked
17.9
17.7
Total
100.0
100.0
*Doll,
1969
not
a
significant
difference
between
the
advice
offered
by
male
and
female
doctors
(X2
=
2.667,
d.f.
=
2,
0.30
>
P
>0.20).
Of
the
1339
doctors
who
replied
to
this
question,
628
(46.9%)
advise
all
patients
against
cigarette
smoking;
588
(43.9%o),
patients
with
certain
conditions;
while
123
(9.2%o)
do
not
advise
patients
at
all.
A
greater
proportion
of
non-smokers
(ex-smokers
and
those
who
never
smoked)
advise
all
patients
as
compared
with
current
smokers.
Current
smokers
tend
to
be
more
selective
by
ad-
vising
patients
with
certain
conditions
(X2
=
38.091,
d.f.
=
2,
P
<
0.001),
and
this
is
especially
seen
among
doctors
who
currently
smoke
cigarettes.
The
proportions
of non-
smokers
and
current
smokers
who
do
not
advise
patients
about
cigarette
smoking
are
very
similar.
A
separate
analysis
indicates
that
in
rank
order,
bronchitis
(acute
and
chronic),
coronary
heart
disease,
pep-
tic
ulcer,
and
peripheral
vascular
disease
are
the
conditions
for
which
doctors
of
both
sexes
most
commonly
advise
patients
to
avoid
cigarette
smoking.
Again,
replies
from
cur-
rent
smokers
and
non-smokers
were
very
similar.
578
A.J.P.H.
APRIL,
1972
Smoking
Habits
of
Medical
Professions
(Male)
in
United
Kingdom
and
the
Republic
of
Ireland
Table
5
compares
the
smoking
habits
of
the
male
medical
profession
in
the
Republic
of
Ireland
1968-9
with
those
of
the
profession
in
the
United
Kingdom,'2
and
a
striking
resemblance
between
the
habits
of
the
profession
in
the
two
countries
is
seen.
Discussion
This
study
of
the
smoking
habits
of
the
medical
profession
shows
that
a
lower
proportion
of
doctors
of
both
sexes
currently
smoke
compared
with
men
and
women
in
the
general
population.
Analysis
of
current
smok-
ing
habit
indicates
that
the
lower
proportion
is
due
to
less
doctors
smoking
cigarettes
only.
Pipe
smoking
in
men
is
very
similar
in
both
groups
and
all
other
forms
of
tobacco
smoking
are
more
common
among
the
doctors.
Four
hundred
and
fifty-six
(28.9%)
doctors
now
smoke
cigarettes.
The
male
average
daily
consumption
is
lower
than
that
of
the
general
population;
but
female
doc-
tors
smoke
more
cigarettes
than
women
in
the
general
population.
Cigarette
smoking,
of
course,
with
its
greatly
increased
death
rates
among
males,
and
to
a
lesser
extent
among
females,
is
the
type
of
smoking
causing
most
con-
cern
since
death
rates
among
cigar
and
pipe
smokers
are
not
appreciably
altered.'
3
When
ex-smokers
are
considered
and
approxi-
mately
90.0%
of
doctors
who
used
to
smoke
have
stopped
for
over
a
year,
almost
three
times
as
many
doctors
of
each
sex
have
ceased
to
smoke
as
compared
with
men
and
women
in
the
general
population.
The
results
also
point
to
the
fact
that
over
the
years
the
proportion
abandoning
the
smoking
habit
has
been
constant,
which
suggests
that
publi-
cation
of
the
reports
on
Smoking
and
Health7"'
had
little
real
impact
on
medical
personnel
as
far
as
cessation
of
smoking
was
concemed.
While
it
is
encouraging
to
see
that
more
doctors
have
abandoned
smoking
as
compared
with
the
population
at
large,
this
requires
careful
interpretation.
Relatively
low
proportions
of
smokers
in
professional
groups
have
been
reported,"41
5,1
6
and
Lynch'
7
has
pointed
out
in
his
study
of
the
smoking
habits
of
medical
and
non-medical
staff
at
Edinburgh
University
that
if
medi-
cal
graduates
have
stopped
smoking
more
than
the
general
population,
this
is
because
they
are
graduates
rather
than
because
they
are
medical.
It
is
to
be
expected
that
ex-smokers
were
more
influenced
by
authoritative
reports
on
smoking
and
health
than
current
smokers;
this,
however,
was
so
for
males
but
not
for
female
members
of
the
medical
profession.
The
reaction
to
reports
of
this
nature
among
current
smokers
influenced
appears
to
be
one
of
reducing
the
quanltity
smoked
or
of
stopping
temporarily
but
apparently
has
a
minimal
effect
on
changing
the
type
of
smoking.
Only
three
cigarette
smokers
changed
their
smoking
habit,
two
changed
to
filter-tip
cigarettes
while
one
started
pipe
smok-
ing.
Pipe
smoking
has
an
appreciably
lower
risk
than
ciga-
rette
smoking
but
there
is
evidence
that
some
reduction
in
the
risk
of
lung
cancer
can
be
achieved
by
cigarette
smokers
switching
to
filter
tips.'8
Doctors
who
were
influenced
were
chiefly
concerned
about
three
conditions
associated
with
smoking
namely,
cancer
of
the
lung,
chronic
bronchi-
tis,
and
coronary
heart
disease.
Platt'
9
has
pointed
out
that
although
cigarette
smoking
is
well-known
to
be
the
main
cause
of
lung
cancer
in
Great
Britain,
and
to
contribute
to
the
development
of
much
respiratory
and
cardiovascular
disease
the
knowledge
has
had
little
effect
in
persuading
people
to
stop
smoking.
A
large
majority
of
doctors
of
both
sexes
agree
that
smoking
is
injurious
but
about
4.0%
do
not
regard
smoking
as
deleterious
to
health.
This
4.0%
is
composed
chiefly
of
cigarette
smokers,
and
one
wonders
if
they
have
read
the
evidence
incriminating
cigarette
smoking
as
a
cause
of
ill-health
and
death.
The
study
of
Spelman
and
Ley20
offers
a
further
explanation,
namely
that
cigarette
smokers
may
deceive
themselves
about
the
risks
they
take;
in
their
enquiry
30.0%
of
heavy
smokers
expressed
the
view
that
lung
cancer
was
frequently
cured
by
treatment,
whereas
less
than
half
this
percentage
of
non-smokers
and
light-smokers
held
this
view.
When
it
comes
to
offering
advice
to
patients,
non-
smokers
are
more
inclined
to
advise
all
patients
against
ciga-
rette
smoking
while
current
smokers
tend
to
be
more
selec-
tive
and
advise
patients
with
certain
conditions
only.
The
principal
conditions
for
which
advice
is
given
are
bronchitis,
coronary
heart
disease,
peptic
ulcer,
and
peripheral
vascular
disease.
The
same
proportion
of
smokers
and
non-smokers
do
not
advise
any
patients.
Green
and
Horn2'
have
shown
that
the
general
public
look
to
their
doctor
for
help
on
smoking
problems,
and
most
people
consider
that
it
is
the
doctor's
duty
to
convince
his
patients
to
stop
smoking
and
to
set
a
good
example
by
not
smoking
himself;
almost
three-quarters
of
the
doctors
agreed
that
it
is
the
physi-
cian's
responsibility
to
set
a
good
example
by
not
smoking
cigarettes.
It
has
been
shown
that
the
smoking
habits
of
the
profession
in
the
Republic
of
Ireland
are
very
similar
to
those
of
doctors
in
the
United
Kingdom.'
2
The
results
are
encouraging
but
they
are
far
from
ideal
in
a
profession
which
is
in
a
special
position
not
only
to
read
and
appreciate
the
scientific
evidence
on
the
hazards
of
smoking,
particu-
larly
cigarette
smoking,
but
who
also
in
their
daily
practices
witness
the
tragic
consequences
of
the
habit.7
If
it
is
ac-
cepted
that
doctors
can
influence
greatly
the
smoking
habits
of
their
patients
and
that
a
doctor
who
smokes
can-
not
with
conviction
advise
his
patients,
or
indeed
the
pub-
lic,
not
to
smoke,
then
obviously
a
great
deal
more
health
education
of
doctors
is
required
before
engaging
in
wide-
spread
and
expensive
health
education
programmes
among
the
general
population.
Summary
The
smoking
habits
of
a
sample
of
the
medical
pro-
fession
in
the
Republic
of
Ireland,
representative
for
age,
sex,
and
specialty,
were
ascertained
by
questionnaire.
The
results
show
that
a
significantly
lower
proportion
of
doc-
tors
of
both
sexes
currently
smoke
as
compared
with
men
and
women
in
the
general
population.
The
lower
propor-
tion
is
due
to
less
doctors
smoking
cigarettes
only,
but
with
SMOKING
HABITS
IN
IRELAND
579
the
exception
of
pipe
smoking
in
men
which
is
very
similar
in
both
groups,
all
other
forms
of
smoking
are
more
com-
mon
among
the
profession.
Approximately
three
times
as
many
doctors
have
ceased
to
smoke
as
compared
with
the
general
population.
Four
hundred
and
fifty-six
doctors
(28.9%)
now
smoke
cigarettes
and
the
average
daily
con-
sumption
for
doctors
is
compared
with
that
of
the
general
population.
The
views
of
doctors
were
obtained
on
the
influ-
ence
of
authoritative
reports
on
smoking
and
health
on
their
smoking
habits;
if
they
considered
smoking
injurious
to
health;
and
whether
or
not
they
advised
patients
to
avoid
smoking
cigarettes.
The
smoking
habits
of
the
male
profes-
sion
in
the
Republic
of
Ireland
are
compared
with
those
of
doctors
in
the
United
Kingdom.
ACKNOWLEDGMENTS
We
are
grateful
to
the
Irish
Cancer
Society
for
a
grant
which
supported
this
study.
Our
thanks
are
also
due
to
the
medical
profession
who
made
the
work
possible
by
their
co-operation.
References
1.
Doll,
R.
and
Hill,
A.
B.
The
Mortality
of
Doctors
in
Relation
to
their
Smoking
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A
Preliminary
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Brit.
med.
J.
1:1451-1455,
1954.
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Doll,
R.
and
Hill,
A.
B.
Lung
Cancer
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Other
Causes
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Death
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A
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the
Mor-
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British
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med.
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1956.
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Doll,
R.
and
Hill,
A.
B.
Mortality
in
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Med.
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1964.
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Snegireff,
L.
S.
and
Lombard,
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Massa-
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1959.
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Gardiner,
C.
E.
and
Taylor,
C.
N.
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Zealand
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No.
16,
Department
of
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Wellington,
N.Z.,
1964.
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Smoking
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Royal
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56,
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Murphy,
T.
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N.
M.
Structure
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the
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in
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J.
Irish
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1968.
9.
Burgess,
A.
M.,
Jr.
and
Tierney,
J.
T.
Bias
Due
to
Nonresponse
in
a
Mail
Survey
of
Rhode
Island
Physicians'
Smoking
Habits
-
1968.
New
Eng.
J.
Med.
282:908.
1970.
10.
Player
and
Wills
(Ireland)
Ltd.
Smoking
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U.
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1103,
1964.
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Doll,
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Personal
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13.
Health
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the
1967
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Health
Service
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580
A.J.P.H.
APRIL,
1972
