Tobacco counseling experience prior to starting medical school, tobacco treatment self-efficacy and knowledge among first-year medical students in the United States

UMMS Affiliation

Clinical and Population Health Research Program; Department of Quantitative Health Sciences, Division of Epidemiology of Chronic Diseases and Vulnerable Populations; Department of Quantitative Health Sciences, Division of Biostatistics and Health Services Research; Department of Medicine, Division of Preventive and Behavioral Medicine; UMass Worcester Prevention Research Center

Publication Date


Document Type



Behavioral Disciplines and Activities | Behavior and Behavior Mechanisms | Community Health and Preventive Medicine | Medical Education | Preventive Medicine | Substance Abuse and Addiction


OBJECTIVE: To explore students' tobacco dependence counseling experiences prior to medical school and their associations with tobacco counseling self-efficacy, and familiarity with and perceived effectiveness of tobacco dependence treatment among first-year medical students in the United States.

METHOD: In 2010, 1266 first-year medical students from 10 US medical schools completed a survey reporting their clinical experiences with specific tobacco counseling skills (e.g., 5As) prior to medical school. The survey also included questions on tobacco counseling self-efficacy, perceived physician impact on smokers, and familiarity and effectiveness of tobacco-related treatments.

RESULTS: Half (50.4%) reported some tobacco counseling experiences prior to medical school (i.e. at least one 5A). Students with prior counseling experiences were more likely to have higher tobacco counseling self-efficacy, and greater familiarity with medication treatment, nicotine replacement treatment, and behavioral counseling for smoking cessation, compared to those with no prior experiences. Perceived physician impact on patient smoking outcomes did not differ by prior tobacco counseling experiences.

CONCLUSIONS: Many first-year medical students may already be primed to learn tobacco dependence counseling skills. Enhancing early exposure to learning these skills in medical school is likely to be beneficial to the skillset of our future physicians.


UMCCTS funding

DOI of Published Version



Prev Med. 2015 Apr;73:119-24. doi: 10.1016/j.ypmed.2015.02.003. Epub 2015 Feb 7. Link to article on publisher's site

Journal/Book/Conference Title

Preventive medicine


First author Rui Sherry Xiao is a doctoral student in the Clinical and Population Health Research Program in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.

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Link to Article in PubMed

PubMed ID