Psychodynamic aspects of smoking cessation among physicians

After approximately 10 years of research on smoking habits with an emphasis on prevention and dishabituation, we focused on the training of teachers and general practitioners. A fairly wide-ranging inquiry within the Communauté francaise de Belgique was conducted among nearly 2000 doctors. The study showed that the proportion of smokers, although lower than the average in the general population, was higher among the doctors than other socio-professional categories. A comparison of the results registered in 1983 and 1991 revealed a decrease in the number of smokers and an increase in the number of non-smokers (those who have never smoked). This change stemmed largely from a sharply lower smoking rate among young doctors. These findings impelled us to study the resistance to dishabituation among doctors who smoked. The inquiry was comprised of non-authoritative, Rogerian-style talks that enabled us to isolate a number of motivating factors and some rather typical defense mechanisms that, until recently, went partly unnoticed. The denial, indeed the placation, of anxieties in the medical profession fostered by the constant confrontation with illness and the challenge of and victory over death apparently plays a crucial role, albeit on the unconscious plane.