Nearly 80% of doctors worldwide mistakenly believe nicotine causes lung cancer, thwarting efforts to hold one billion smokers quit, according to a survey conducted in 11 countries. The survey of 15000 doctors in 11 countries – China, Germany, Greece, India, Indonesia, Israel, Italy, Japan, South Africa, UK, and the US – has been conducted by Sermo and funded by the Foundation for a Smoke-Free World. The survey is aimed at developing actionable insights for accelerating an end to smoking. Sermo is an independent platform and leader in actionable healthcare professional insights.

The physicians surveyed are full time, licensed to practice, with a minimum of two years’ experience, who spend at least 50% of their time in direct patient care, seeing a minimum of 20 adult patients per month. They work in a broad range of specialties from family/general practice to internal medicine, cardiology, pulmonology, oncology, and psychiatry.

According to the survey, a significant majority of doctors worldwide mistakenly attributes negative health consequences of smoking to nicotine. Of them, 78% think nicotine causes atherosclerosis, while 77% said it causes lung cancer, followed 76% who hold nicotine responsible for COPD, 72% birth defects, 71% head/neck gastric cancers, and 69% bladder cancer.

Even though 78% of physicians at least moderately agreed with the statement that “In adult patients, most harm caused by smoking comes from combustion rather than nicotine itself,” when specifically asked, an average of 73% of doctors at least moderately agree that nicotine causes lung, bladder, and head/neck/gastric cancer.

In nearly all 11 countries surveyed, a large majority of physicians are interested in training about smoking reduction/cessation. However, many tend to focus on general cessation rather than specific alternatives to smoking.

In all countries a large majority of physicians – ranging from 71% to 94% – agree that helping patients quit smoking is a priority. On average, one fourth of physicians report never having participated in training about smoking cessation. Lack of opportunity and lack of awareness are the most common reasons for not taking training. In nearly all countries, at least 80% of physicians are interested in training about smoking reduction/cessation, though reported interest does not always match real-world participation.

In Pakistan also, an overwhelming majority of doctors mistakenly believes nicotine is carcinogenic. In a survey conducted by Alternative Research Initiative (ARI) in 2022, more than two-thirds of doctors (70%) strongly agreed and 17.9% somewhat agreed with the statement that nicotine causes cancer. Almost 80% doctors strongly agreed with the statement that nicotine causes cardiovascular disease while 81.6% held it responsible for COPD. Similarly, 61.7% strongly agreed that nicotine causes birth defects. Majority of doctors who had specific smoking cessation training strongly agreed that nicotine contributed to cancer (73.2%), cardiovascular disease (82.1%), birth defects (64.3%) and COPD (89.3%), respectively. Similarly, doctors with no specific smoking cessation training also strongly agreed that nicotine contributed to cancer (69.4%), cardio-vascular disease (79.4%), birth defects (61.2%), and COPD (80.1%).