Medical students don't receive enough training in helping patients quit smoking

WINSTON-SALEM, N.C. Though tobacco use remains the leading cause of preventable death in the United States., medical schools are not doing enough to train medical students to help their patients quit smoking, a Wake Forest University School of Medicine research team reports in the Sept. 4 issue of the Journal of the American Medical Association.

John G. Spangler, M.D., M.P.H, associate professor of family and community medicine found that part of the problem is that no national curriculum models exist for teaching medical students this vital clinical skill.

After reviewing medical education research studies, Spangler and colleagues found that a number of "enhanced" teaching approaches to training medical students in smoking cessation counseling work better than traditional lectures and handouts. These methods include patient-centered counseling techniques, use of standardized (or "mock") patients, and role playing.

Nonetheless, gaps still exist.

"Tobacco use and dependence are not integrated throughout the four years of medical school curricula," Spangler said, "and no national curriculum exists on what should be taught to medical students regarding the harms of tobacco use or how to help patients quit."

Smokeless tobacco use and cessation are virtually ignored, he said. "No one has studied successful ways to train medical students to help people quit this habit which is also harmful and addictive."

Spangler said most current smokers would quit if their doctor told them directly to do so. "Several studies have documented physicians' failure to counsel their patients to stop smoking." He added, "Physicians often perceive they are ill prepared in treating patients addicted to nicotine." A majority of medical school graduates "still are not adequately trained to treat nicotine dependence."

The research team reviewed a number of studies in analyzing various educational methods of teaching medical students how to help pa

Contact: Robert Conn, Jim Steele or Mark Wright
Wake Forest University Baptist Medical Center

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