CHINESE CARDIOLOGISTS CHAMPION TOBACCO CONTROLIn China, nearly 30% of all male cardiologists still smoke. Professor Dayi Hu, President of the Chinese Cardiology Society of the Chinese Medical Association, aims to improve quality of care in China by mobilizing cardiologists to quit smoking. Improving patient outcomesCardiovascular patients who quit smoking improve their outcomes. When a doctor smokes, it makes it harder to be credible when advising patients to quit. “For physicians,” Professor Hu explained, “smoking is more than a question of personal choice; it is a question of professional performance and of our obligation to our patients to give the best care possible. We cardiologists are powerful because we have a big influence on our patients, especially after acute events when they often feel the real meaning of the risks they take. If we convince them to quit, we significantly reduce their chances of having another heart attack. If we pass up this opportunity we are not doing our best to protect their heart health.” Mobilizing cardiology networksSince 2002, Professor Hu has worked tirelessly to mobilize cardiologists to counter the tobacco epidemic. He has organized forums on tobacco use at the Great Wall of China Cardiology Congress and other major training events. In 2008, he worked through the Chinese College of Cardiovascular Physicians to establish an Experts’ Consensus on Smoking Cessation, and to develop tools for training in tobacco cessation treatment. Committing to actionTo help focus and orient action, Professor Hu developed a declaration which outlines cardiologists’ core obligations related to tobacco use. Integrated routinely into cardiology congresses in China, the declaration is a pledge to:
Changing norms about physician smokingIt is hard to solve the problem of physician smoking by influencing individuals alone. “If a Chief lights up,” Professor Hu points out, “you just can’t expect young doctors to refuse to smoke with him. So we decided that the best way to reach all cardiologists is to start with the heads of the cardiology departments.” As part of this campaign, each year at the Great Wall Congress of Cardiology two awards are presented to heads of cardiology departments: one for quitting smoking and another for establishing a smoke-free department”. Successes and challengesHave these strategies worked? There have been some impressive achievements: the Chinese Ministry of Health has integrated assessment of smoking status into the physician’s daily practice and cardiologists now routinely ask about each patient’s smoking profile. Tobacco content has been integrated into cardiology curricula, qualifying examinations and continuing education. A survey established the baseline on cardiologist smoking behaviour before the campaign and it will be repeated at the end to measure its impact. “We already know that about a third of the cardiology directors around the country have quit smoking and established a smoke-free department,” reported Professor Hu. “This should make it easier for both patients and the health professionals who treat them to quit, and supports the recent Ministry of Health declaration that all Chinese hospitals must go smoke-free by 2011”. But Professor Hu admitted that there are challenges ahead: “There is still some resistance: some heads of departments refuse to quit and even where we establish smoke-free hospitals you can sometimes still smell smoke in the bathrooms”. Collaborating with other specialtiesIn their efforts to take on tobacco use, Chinese cardiologists have worked closely with other specialties. “Before cardiologists got involved, respiratory specialists were working more or less alone to reduce tobacco use,” recounted Professor Hu. “We now work closely with them and have benefitted a great deal from their expertise and experience. We cardiologists can bring a real added value, because we have a lot of influence within the medical world: when we joined in promoting tobacco cessation and control, then other physician groups followed”. Cardiologists’ special role in tobacco controlAs specialists in heart health, cardiologists have a key role in the interpretation and promotion of knowledge on the risks tobacco poses to the heart. This responsibility becomes even greater as new evidence emerges on the cardiovascular impact of secondhand smoke and the enormous benefits to heart health brought by strong smoking bans. Most recently, Professor Hu joined many other physicians to sign a letter to the Chinese government to ask it to withdraw its support for tobacco production. He explained: “China produces and consumes more tobacco than any other country in the world. How can Chinese cardiologists ignore tobacco risk? Our government has ratified the Framework Convention on Tobacco Control and the Beijing Olympics brought a chance to implement and enforce smoking bans: for the sake of our patients, profession, health system and economy we really must be sure that the momentum for establishing strong tobacco control continues to grow”. World Congress of Cardiology to highlight links between tobacco and CVDThe World Congress of Cardiology to be held 16–19 June in Beijing, will feature global experts in tobacco control and highlight the work of Chinese cardiologists as a model for strengthening cardiologists’ engagement to combat tobacco as a cardiovascular risk. With funding from the Flight Attendant’s Medical Research Institute, the Global Smokefree Partnership is working with the World Heart Federation, the US CDC and Roswell Park to produce a film on the cardiovascular effects of secondhand smoke and their implications for cardiologists. Professor Hu will also present findings on the impact of his work. Further information Read more on the World Congress of Cardiology and find out how to register > | |||||||
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