Smoking status of resident physicians and their knowledge and attitudes regarding smoking cessation treatment

Aim: This study aimed to determine the smoking status of resident physicians working in a university hospital and to analyze their knowledge levels and attitudes regarding smoking cessation treatment. Materials and methods: This cross-sectional study was conducted between November 1, 2024, and February 28, 2025, with resident physicians working at Samsun University Faculty of Medicine Training and Research Hospital. The data collection form, prepared by the researcher, consisted of 29 questions: 9 sociodemographic questions, 4 attitude questions (5-point Likert scale), 9 multiple-choice knowledge questions, 1 open-ended question (for smokers only), and the 6-item Fagerström Test for Nicotine Dependence. Data were analyzed using SPSS 26.0, and a p-value <0,05 was considered statistically significant. Results: The study included 224 resident physicians with a mean age of 30,3 years and an average professional experience of 5,5 years. Of the participants, 54% were female, 56,7% were married, 81,7% worked in internal medical sciences, and 31,7% were smokers. While 26,4% had received tobacco addiction training, only 2,7% were certified, and 19,6% had provided smoking cessation counseling. A statistically significant association was found between gender and smoking status (p<0,001), as well as between years in profession and smoking behavior (p=0,028). Tobacco addiction training and counseling experience significantly differed by medical specialty (p<0,001 and p=0,028, respectively). Among the participants, 44% had low and 46,7% had moderate nicotine dependence. No significant associations were found between dependence level and demographic variables, training/counseling experience, or knowledge level; however, those with higher dependence tended to have lower knowledge levels. While 95,1% of participants considered smoking cessation counseling important, only 34,9% felt competent in this area. Physicians working in internal medicine viewed counseling as more important (p=0,002), felt more competent (p=0,007), and found their residency training more preparatory (p<0,001). Internal medicine residents had significantly higher knowledge levels than those in surgical fields (e.g., correct identification of treatment medications: 43,2% vs. 7,3%; p<0,001). Perceived competence and the perceived importance of counseling were significantly associated with specific areas of knowledge (p<0,05). No overall significant relationship was found between undergraduate medical education and knowledge level; however, residents who found their specialty training adequate had higher knowledge scores (p<0,05). Among surgical residents, cigarette consumption differed significantly by dependence level (p=0,001), but average consumption did not differ significantly by specialty (p=0,409). Conclusion: Our study revealed that resident physicians' knowledge and perceived competence regarding smoking cessation counseling are inadequate, and that medical and specialty education are not considered sufficiently preparatory for this role. Although internal medicine residents demonstrated more favorable outcomes in terms of knowledge, awareness, and competence, it is concluded that training and awareness activities need to be enhanced across all disciplines to improve the effectiveness of smoking cessation counseling. Keywords: Smoking cessation counseling, Tobacco dependence, Education level, Attitude, Knowledge