Recommendations for addressing smoking among doctors in Laos

Doctors in Laos, a low-income country in Southeast Asia where community smoking prevalence is high, are prepared to contribute to tobacco control programs if equipped with the appropriate tools, according to a study assessing smoking prevalence among Laotian medical doctors. The study also makes government recommendations to engage doctors in tobacco control.

The study found that 9.2 percent of medical doctors in Laos are current smokers, the majority being male (17.3 percent, compared to only 0.4 percent of female doctors) and older. Over 84 percent of current smokers wanted to quit, and 74.7 percent had made a recent serious attempt to do so. More than 18 percent were ex-smokers.

Doctors had excellent knowledge about the harms of smoking and had positive attitudes towards quitting, but the large majority lacked confidence in providing assistance for cessation, with few having undergone training. Three-fourths of doctors were engaged in cessation support, but just 24 percent had been trained to do so, and a mere 8.8 percent considered themselves ‘well prepared.’

“The willingness of doctors to take up their tobacco control role and the lower smoking rates among younger respondents offers an important window of opportunity to consolidate their knowledge, attitudes, skills and enthusiasm as cessation advocates and supports,” the study concluded.

Recommendations for the Laos Ministry of Health

The study offered the following recommendations to engage doctors in smoking prevention and cessation more actively:

• Targeted cessation support for doctors to assist their quit attempts and bolster their image as role models for non-smoking;
• Training programs for doctors (and medical students) on brief advice and cessation counseling to enable them to support patients and community;
• Training programs for lower level health professionals in cessation support to reach greater numbers of the Lao population;
• Expansion to all regions of nicotine replacement therapy and medications of proved effectiveness to aid cessation;
• Medical school and in-service education for doctors (and health professionals) on the health, financial and other costs of tobacco use;
• Raising consciousness for doctors and the broader community about the negative impacts of gender norms for men and boys that encourage tobacco uptake; and
• Implementation of Framework Convention on Tobacco Control (FCTC) measures of greatest impact on prevention and cessation of tobacco use, including price increases and strict enforcement of smoking bans in workplaces and public spaces.

Source:
1. Vanphanom S, Morrow M, Phengsavanh A, et al. Smoking among Lao medical doctors: challenges and opportunities for tobacco control. Tobacco Control 2011; 20: 144-150. (open access)

Bed nets prevent malaria when used in farming huts in Laos

Bed nets prevent malaria infection

Overnight stays in farming huts are known to pose a risk of malaria infection. But a study conducted among farmers in rural Laos suggests that malaria infection is likely preventable if insecticide-treated bed nets are properly used in farming huts.

Malaria is the leading cause of illness and death in Laos, with 70 percent of the population at risk. Most of the Laotian population lives in rural areas and 84 percent of households engage in rice farming. During the rice farming season, farmers and their family members often move from their village to a farm, where they stay in a temporary shelter (farming huts).

“The finding is important not only because overnight stays in farming huts are reported in malaria endemic countries other than Laos, but because overnight stays in farming huts are not confined to adult population,” the study reported. Children under age five years, those most vulnerable to malaria infection, are usually taken to the farming huts by their parents.

Source:
1. Nonaka D, Laimanivong S, Kobayashi J, et al. Is staying overnight in a farming hut a risk factor for malaria infection in a setting with insecticide-treated bed nets in rural Laos? Malaria Journal 2010; 9: 372. (open access).