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Journal of the Korean Academy of Family Medicine 1995;16(6):347-361.
Published online June 1, 1995.
The smoking patterns in the family physicians.
Hyun Rim Choi, Joo Yeon Kim, Kwang Bae Kim, Sang Sook Hwang
가정의학과 의사의 흡연 양상
최현림, 김주연, 김광배, 황상숙
Abstract
Background
: The prevalence of smoking has declined continuously in the developed countries since 1960 due to various antismoking policies, but that remains high in Korea. The surveys of smoking habits of physicians are rare as compared with those of general populations in Korea. In this situation, we surveyed to obtain the basic data for the antismoking activities by the survey of family physicians' smoking patterns who are primarily contact with patients.

Methods : To investigate the smoking habits of family physicians, a qustionnaire was mailed two times in July 1993 to 2,528 family physicians who are legistrated in the Korean Academy of family Medicine. After we excepted 37 incomplete questionnaires among 1,122 respondents, we analysed 1,085 complete questionnaires by the classification of cigarette smoking status and speciality status.

Results : Among the total respondents of 1,085, family residents were 13.9% and family specialists were 86.1%. The sex ratio of residents was 1.7:1 and specialists 4.6:1. The proportion of nonsmoker, ex-smoker and smoker were 38.3%, 35.1% and 26.6% respectivly. And the proportion of male smokers among the residents and specialists were 53.6% and 30.5% respectively. The smokers had 84.0% of smokers in their family. The most common reason for the initiation of smoking was curiosity(45.0%) and the differences of reason between ex-smokers and smokers were statistically significant. 46.9% of all smokers daily consumed less than 15 cigarettes and the amount of daily smoking by ex-smokers was significantly much more than that by smokers. 42.3% of smokers took first morning smoking within 30 minutes after getting up and it was sigificantly higher than that of ex-smokers. Of the why test for smoking patterns, stress solution(30.3%) was the most common reason for smoking among all smokers, and by the smoking behavior, nicotine dependence was the highest in smokers but stress solution was the highest in ex-smokers and by the duty, stress solution was the highest in residents but nicotine dependence was the highest in specialists. Smokers who had ever tried to quit smoking were 78.5% of smokers and health problem was the most common reason to quit smoking. Most of nicotine withdrawal symptom peaked in 2 to 4 days after quitting and this prevalence was 49.8% of all smokers. The drinking habit of smokers was poor compared to the others and the habit of health promotion of ex-smokers was good compared to the others.

Conclusion : The smoking habits of family physicians was better than those of the general population but those of male physicians, especially male residents were worse than females. Recognizing the core of primary care, the family physician shoud make efforts to quit smoking for themselves so that their exemplary role contributes to patient's smoking behaviour and assists patients to quit smoking.
초록
연구배경 : 1960년대 이후 선진국에서는 다각적인 금연정책으로 흡연율이 계속 감소하고 있는 추세이나 우리나라의 흡연율은 아직 높은 상태를 보이고 있다. 우리나라의 일반인에 대한 흡연실태조사는 다방면에서 시행되었으나 의사의 흡연 실태조사는 미흡한 실정이다. 이러한 상황에서 환자와 일차적인 접촉을 하는 가정의에 대한 흡연 실태를 조사하여 금연운동의 기초자료로 삼고자 하였다.

방법 : 대한가정의학과 학회에 등록된 가정의 2,528명(전문의 2,122명, 전공의 406명)을 대상으로 1993년 7월에 우편을 이용한 2차례의 설문조사를 시행하여 이에 응답한 1,122명의 설문중 응답이 불성실한 37명을 제외한 1,085명의 설문을 흡연 양상군별 및 직위군별로 구분하여 SPSS/PC+를 이용하여 분석하였다.

결과 : 조사대상의 직위별 분포는 전공의가 13.9%, 전문의가 86.1%였고 남녀의 성비는 전공의가 1.7:1, 전문의가 4.6:1이었다. 흡연 양상별로는 비흡연자가 38.3%, 과거흡연자가 35.1% 및 흡연자가 26.6%이었고 남자 전공의 흡연율은 53.6%, 남자 전문의 흡연율은 30.5%이었다. 가족원 흡연자는 흡연자군이 84.0%로 가장 많았으며 흡연동기는 담배에 대한 호기심이 45%로 가장 높았고 과거흡연자군과 흡연자군에 사이에 유의한 차이가 있었다. 일일 흡연량은 15개비 이하기 46.9%로 가장 높았고 과거흡연자군의 흡연량이 유의하게 높았으며 흡연자군의 42.3%가 아침 기상 30분 이내에 하루 첫 흡연을 하였으며 과거흡연자군과 유사한 차이가 있었다. 흡연 유형별로는 전체에서 스트레스 해소형이 30.3%로 가장 높았고, 흡연 양상별 분류에서는 흡연자군은 중독형이, 과거흡연자군은 스트레스 해소형이 가장 높았고 직위별로는 전공의 스트레스 해소형이, 전문의는 중독형이 가장 높았다. 금연시도는 78.5%에서 있었으며 금연시도의 동기로 65.5%에서 담배가 건강에 해롭기 때문이라고 지적하였고, 니코틴 금단증상의 시기로는 49.8%가 금연후 2~4일에 가장 많았다. 흡연자군에서 다른 군보다 상대적으로 음주습관이 불량하였고 과거흡연자군에서 다른 군보다 상대적으로 건강행태가 양호하였다.

결론 : 가정의의 흡연형태는 일반인 보다는 양호하였으나 남자의 흡연율이 높았으며 특히 남자전공의의 흡연형태가 불량하였다. 일차의료의 핵심 역할이 가정의에게 있음을 인식할 때 가정의 스스로가 금연을 실천하여 환자에게 모범이 됨으로서 환자의 금연에 노력을 기울여야 할 것이다.


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