Getting Personal

Vices: Who needs them?

Not doctors, apparently. Though they're not teetotalers, they rarely smoke or use illegal drugs.

By Wayne J. Guglielmo,
Senior Editor

When it comes to illegal drug use and tobacco, doctors apparently practice what they preach—with some exceptions.

Although 23 percent of Americans smoke cigarettes, according to a recent Gallup poll, that figure was only 3 percent for our survey respondents. Less than 5 percent of doctors smoke cigars, and just 1 percent favor pipes. More than 92 percent say they don't smoke at all.

Male doctors are somewhat more likely to smoke cigarettes than female doctors, our survey found, but five times more likely to light up a stogie. (In fact, there were only three female physicians who 'fessed up to smoking cigars.) No dramatic differences show up when age, religion, and specialty are taken into account. But when marital status is considered, there's a slight increase in cigarette smoking among divorced, widowed, or separated doctors.

General surgeons are the biggest smokers in our survey. More than 6 percent smoke cigarettes, while another 6 percent smoke either cigars or pipes. The highest cigar use was among ob/gyns—7 percent. Pediatricians and internists smoke the least.

Abstinence is the rule among doctors when it comes to illegal drug use. When asked whether they'd ever used marijuana or other illegal drugs, only 16 percent said Yes, with males and females responding similarly. In contrast, 34 percent of adult Americans in a recent Gallup poll say they've at least tried marijuana.

Doctors today are apparently less inclined to experiment with drugs, marijuana in particular, than their colleagues some 20 years ago. When we asked about marijuana use back then, 10 percent of doctors said they smoked it, at least on rare occasions. Today, the percentage answering Yes drops below the radar screen. Barely 1 percent admit to currently using "any illegal drugs for recreational purposes."

In the past, the AMA has estimated that 1 to 2 percent of all physicians are drug abusers, but solid figures are hard to come by. "Surveys based on self-reports are likely to underestimate the prevalence of chemical impairment among those surveyed," cautions Robert Holman Coombs, an addiction specialist at UCLA School of Medicine, in his book "Drug-Impaired Professionals" (Harvard University Press, 1997).

Among today's doctors who've admitted to using drugs in the past, those in the 40 to 49 age group are more than three and a half times more likely to have done so than doctors 60 and older. More dramatically, Jewish doctors who responded to our survey are six times more likely to have tried marijuana or other illegal drugs than Islamic doctors, and 20 times more likely than Hindu doctors. When specialty is factored in, psychiatrists, anesthesiologists, pediatricians, and ER specialists—in that order—are most likely to have experimented, while FPs/GPs, ophthalmologists, and internists are the least likely.

Although doctors may smoke less and use fewer drugs than adult Americans generally, they're about equally as likely to drink alcoholic beverages. Two-thirds of the doctors we surveyed say they drink, compared with 64 percent of adult Americans.

Male doctors are more likely to drink alcohol than female doctors, but the gap between the sexes—69 percent to 61—isn't dramatic. As a group, however, today's doctors are less likely to consume alcoholic beverages than their colleagues of 20 years ago. Eighty-eight percent of respondents to our survey back then said they drank, at least occasionally.

Among today's doctors who say they drink, solo physicians and those in partnerships are less likely to consume alcohol than doctors in hospital-based or group practices. Roughly seven in 10 Catholic, Jewish, and Protestant physicians say they drink, while only four in 10 Hindu doctors and two in 10 Islamic doctors say they do. Among the specialties, psychiatrists, anesthesiologists, ER specialists, and orthopedic surgeons are more likely to be drinkers than FPs/GPs, pediatricians, and internists.

Doctors and tobacco: Their smoking habits...¹

Doctors and illegal drugs:
Users (now or ever) vs abstainers

Doctors and alcohol: Drinkers vs teetotalers

 

Wayne Guglielmo. Vices: Who needs them?. Medical Economics 2000;19:189.