Time-trends (1983-1998) in smoking habits among Belgian physicians

A cross-sectional survey was conducted by the Belgian Lung and Tuberculosis Association (BELTA) in 1998 in a randomly selected sample of 4643 Belgian physicians and the results were compared with those of a similar survey conducted in 1983 among 3205 physicians. Both studies were founded on self-completed questionnaires with no biological validation of the smoking status. In 1998, the response rate was 64.8% for questions about the smoking and personal status, but 35.9% only for the other items. Among the responders 17.3% were current, 28.7% former and 54.0% never smokers. With age, the rate of never smokers decreased and that of former smokers increased, whereas the rate of current smokers showed a symmetrical distribution forage. More male than female physicians were smoking: 19.4% versus 11.3% (p < 0.001). No major differences in smoking rates were noted between GP's, certified specialists, specialists in training and other physicians. Among smokers, 61.6% were smoking daily and 38.4% occasionally; 62.0% smoked cigarettes and 44.4% other tobacco products. The median cigarette consumption was 12 per day for daily smokers; the Fagerstrom nicotine dependence test (FNDT) of smokers was very low (median value = 1). Of former smokers 92.5% had quitted by personal decision only, but 52.7% reported unsuccessful earlier quit attempts. Since the large number of non-responders could cause a selection bias, a correction model was used, yielding a total smoking prevalence rate of 18. 1%, which is notably lower than that in the general population of Belgium (30%). The smoking rate among physicians markedly decreased since 1983, when it amounted to 32%. This is due to the increase of never smokers in the numerous young physicians' group rather than to the increase of former smokers in the less numerous older physicians. The smokers' rate of belgian physicians remains still higher than that among physicians in several other countries (< 10%).