Tobacco (68) The role of health professionals (8) Tobacco use by medical students

22 March, 2023

If logic were the only driver of behavior, this article (which we published back in 2007) was supposed to take care of this problem of medical student cigarette smoking and its clear effect on patient health...

A Quantitative Assessment of a 4-year Intervention That Improved Patient Counseling Through Improving Medical Student Health

Objective: Despite efforts to produce healthier physicians and patients, there are no published experiments where health promotion interventions throughout medical school have been compared with a control group regarding the school environment, students' personal health practices, and students' patient counseling practices.

Design: Using the Class of 2002 as controls, we performed a 4-year pilot study of a personal health promotion intervention on the Class of 2003 at Emory University School of Medicine (EUSM). We focused on improving the actual and perceived healthfulness of the educational milieu, and on improving their personal and clinical practices about diet, tobacco, exercise, and alcohol use. Data were collected at freshman and ward orientations and during a senior rotation (ncontrols= 110, 109, 100 and ntreatment=114, 104, 106; all response rates greater than 90%).

Results: Students receiving the intervention perceived EUSM as a healthier environment than did control students. By senior year, control males reported twice the tobacco use reported by males in the intervention (43% vs 22%, P = .02), although they had previously reported very similar levels (31% vs 29%, P = .8). Diet, exercise, and tobacco counseling practices were positively related to the intervention; alcohol was inversely related to the intervention.

Conclusions: In this pilot, compared with controls, the intervention positively affected medical students' perceptions of their school health promotion environment, reduced tobacco use among male students and, to some extent, improved their patient counseling practices. Such a medical school-based health promotion intervention shows promise and should be studied in a broader setting.


Erica Frank, MD, MPH, FACPM

Professor, University of British Columbia Faculty of Medicine


Principal Investigator, Healthy Doc = Healthy Patient

HIFA profile: Erica Frank, MD, MPH, is the Canada Research Chair in Preventive Medicine and Population Health at the University of British Columbia and the Founder (in 2001) of Dr. Frank has served as a tenured Professor, Vice-Chair, and Division Director in the Department of Family and Preventive Medicine at Emory University School of Medicine in Atlanta, Georgia, and served as Research Physician, Medical Epidemiologist, and Medical Consultant at the U.S. Centers for Disease Control and Prevention. She has published over 170 peer-reviewed articles, is conversant in French; and is a citizen of Canada, Germany, and the United States of America. Dr. Frank has also conducted research and published abstracts on domestic violence, and intimate partner violence (IPV). Dr. Frank’s Wiki page can be found here: