Postgraduate medical education on tobacco and smoking cessation in Europe

Issues. Smoking prevalence in European countries is high. Adequately trained physicians can play a key role in reducing smoking rates in Europe. This paper provides an overview of postgraduate smoking cessation training for physicians in Europe. Approach. Two methods were used: (i) a review of the Europe-based published and grey literature between 1999 and 2009 on postgraduate education programs for physicians in smoking cessation; and (ii) a survey of key informants identified through two European tobacco control list serves. Key Findings. A total of nine relevant articles were identified through the literature search which showed over 170 postgraduate training programs offered in Europe in smoking cessation. The survey resulted in a 100% response rate from 38 key informants from 28 European countries. Respondents from all countries except Latvia reported knowledge of the existence of smoking cessation training programs. Course content included brief intervention training (93%), pharmacotherapy (96%), motivational interviewing skills (85%) and training in the stages of change (89%). Participation by physicians in these courses was reported to be low (ranging in total participation estimates from 15 to 1100 per country). Implications. The study showed numerous training opportunities for physicians in Europe. However, postgraduate training in smoking cessation might not be reaching physicians and might not be rigorously evaluated. Conclusions. It is imperative that the effectiveness of the programs in changing provider practices and patient smoking outcomes is adequately evaluated. Further research is also indicated for methods of disseminating effective educational activities throughout Europe with the intention of increasing participation. [Kralikova E, Bonevski B, Stepankova L, Pohlova L, Mladkova N. Postgraduate medical education on tobacco and smoking cessation in Europe. Drug Alcohol Rev 2009;28:474-483].