Tobacco Control: Are We Appropriately Training Future Professionals?

Information on how health professionals perceive tobacco use as well as their attitudes toward tobacco control is scarce. This study assessed the attitudes and perceptions of public health students toward tobacco use and tobacco control, which constitutes a necessary first step in designing effective training strategies. Although the majority of respondents agreed that tobacco use constitutes a relevant public health problem, they did not perceive tobacco control to be a public health priority. Academic institutions may not be properly training public health students, and may therefore be missing the opportunity to advance tobacco control at the national and global levels. The need for effective tobacco control initia tives has been sufficiently established. Smoking continues to be the single most important cause of preventable death in the US, responsible for 440,000 deaths yearly (CDC, 2002). Globally, tobacco kills almost 5 million people annually, and by the year 2030, smoking will be responsible for 10 million deaths per year. This represents higher mortality than that caused by AIDS, tuberculosis, traffic accidents, killings, and suicides altogether (World Health Organization, 2002). One of the US public health objectives for the year 2010 is to reduce the prevalence of cigarette smoking among adults to <12% (objective 27.1a) (USDHHS, 2000). Despite the consistent decline in smoking prevalence from 25% in 1993 to 22.8% in 2001, a recent study by the CDC estimated that overall prevalence is not decreasing at a rate that will meet the national health objective by 2010. The study recommends an increased emphasis on state-level comprehensive tobacco control programs (CDC, 2003). Such programs consist of a combination of interventions and initiatives with the goal of reducing tobaccorelated disease, disability, and death. PUBLIC HEALTH STUDENTS AND TOBACCO CONTROL The response of public health to the devastating consequences of tobacco use includes the implementation of “evidence-based” state and community level interventions that involve education, prevention and smoking cessation programs for youth and adults, advocacy and policy development, and counter-marketing campaigns. In this context, “evidence-based” implies strong evaluation and management components (CDC, 1999). The CDC’s recommendations mean that states willing to implement comprehensive programs must rely on highly skilled personnel and support staff. Best Practices for Comprehensive Tobacco Control Programs, the CDC’s sponsored guide for planning and implementing state level programs, consists of a multifaceted intervention aimed at: 1) preventing the initiation of tobacco use among young people, 2) promoting quitting among young people and adults, 3) eliminating nonsmokers’ exposure to environmental tobacco smoke (ETS), and 4) identifying and eliminating the disparities related to tobacco use and its effects on different population groups. The CDC recommends that Francisco Soto Mas, MD, PhD, MPH is affiliated with the Department of Social and Behavioral Sciences, School of Public Health at the University of North Texas Health Science Center. Julia Valderrama Alberola, MD, MPH is affiliated with the Pan American Health Organization in Washington, DC. Jan Brogger, MD, PhD is affiliated with the Center for Clinical Molecular Medicine and Medical Genetics at the Haukeland University Hospital. Chiehwen Ed Hsu, PhD, MPH is affiliated with the Department of Public and Community Health at the University of Maryland. Address all correspondence to Francisco Soto Mas, Department of Social and Behavioral Sciences, School of Public Health, University of North Texas Health Science Center, 1900 Tremont Ave., Fort Worth, Texas 76107; PHONE: 817-763-5701; FAX: 817-763-5701; E-MAIL: [email protected].