|LETTER TO THE EDITOR
|Year : 2021 | Volume
| Issue : 4 | Page : 764-765
Smoking oncologists – Hippocrates or hypocrites?
Indranil Ghosh, Rajib Bhattacharjee
Department of Medical Oncology, Apollo Multispecialty Hospitals, Kolkata, West Bengal, India
|Date of Submission||31-Oct-2021|
|Date of Decision||08-Nov-2021|
|Date of Acceptance||14-Nov-2021|
|Date of Web Publication||29-Dec-2021|
Department of Medical Oncology, Apollo Multispecialty Hospitals, Kolkata, West Bengal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ghosh I, Bhattacharjee R. Smoking oncologists – Hippocrates or hypocrites?. Cancer Res Stat Treat 2021;4:764-5
We read with interest the study titled, “Patterns of smoking among oncologists of Eastern India: A questionnaire-based survey,” published recently in your Journal. This paper raises some important issues surrounding smoking patterns among oncologists, those who themselves are expected to promote smoking cessation among their patients. However, the results of this study may not be generalizable to the entire country because of the prevalence of different smoking patterns across India. There are few points we would like to raise. It has already been highlighted that only 2% of the respondents were females. Readers would also like to know the proportion of respondents among all the female oncologists who were approached. If this proportion was lower than that for the males, then the results might have been skewed because of it. We noted that while discussing quitting efforts, the authors combined 26 never-smokers with 50 ever-smokers. The never-smokers by definition smoked <100 cigarettes in their lifetime. Hence, if we keep this group as a variable influencing the quitting rate, it could possibly have introduced bias as practically all of them had quit, as per the definition of the group itself. This would be akin to claiming that survivors are more likely to survive a certain condition. This, in turn, could have resulted in the significantly higher quitting probability reported among those who smoked less than 100 cigarettes in their lifetime. In our opinion, these 26 never-smokers should be excluded from any quitting analyses. Rather, we would like to know the factors that prevented quitting in the ever-smokers, such as the age of onset, duration of smoking, and level of smoking. Although this was not a part of the current study, some data comparing smoking prevalence between oncologists and non-oncologists can provide information as to whether it is less or paradoxically more among Indian oncologists.
The authors mentioned that the stress associated with the medical profession is a major cause for smoking, but this is unfounded in the study itself, where peer pressure was the most important driver for smoking onset. This is also supported by a study from Kashmir, which showed that 80% of the students started smoking because of peer pressure. In addition, majority of them started smoking even before they took admission in the first place.
We believe that smoking is a multifactorial problem and family influences play a far more important role than is attributed to them. In a survey conducted in Seattle, 808 urban children aged 10–11 years were interviewed and followed prospectively till 21 years of age. The authors found that parental smoking had a definite impact on smoking onset in children. On the other hand, more family monitoring and stronger family bonding reduced the risk of smoking initiation. Another study showed that having one parent with a significant smoking history increased the daily smoking behavior in children, compared to families with both non-smoking parents. Whether this hypothesis held true for our group of smokers as well could have been ascertained by collecting data on how many of the smokers and non-smokers had smokers in their family and then calculating an odds ratio from it.
To conclude, the vice of smoking among oncologists is a real problem and has to be tackled by systematic research and early intervention, which in turn can improve the delivery of care to their patients, as well as cater to their own health.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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