Smoking habits and attitudes of medical students towards smoking and antismoking campaigns in fourteen European countries.

From an ongoing global international survey we present the results for 14 European countries. The survey was carried out through a WHO-based questionnaire given to the students at the beginning of their first year and during the course of their final year. Daily smokers comprised 13.7% in first year and 21.5% in final year, with an overall variation between 3 and 33% according to country. There were already 16% of ex-smokers among first year students. More than 50% of smokers had made attempts to quit. 60% of daily smokers, and almost all others, thought that they would no longer be smoking in five years time. Knowledge of aetiology was moderate in first year. It later improved but there remained many lacunae in final year, e.g. less than 30% were aware that smoking was a cause of coronary artery disease. There was little knowledge of public health measures for smoking control. Attitudes were greatly influenced by smoking; ex-smokers were similar to non-smokers, with occasional smokers intermediate between these and daily smokers. Only 25% accepted a preventive and educative role in advising patients. As regards smoking, students were concerned with their personal health and with advising patients whom they knew to have smoking-related disease, but in general had little conception of smoking as a public health problem. The differences between countries indicate that both habits and attitudes are social and cultural problems. In most of the centres there seemed to be much room for improvement of medical education in this field.