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Editor,—Because of the social status of religious professionals and their potential to influence Turkish society, we surveyed them in 1997 to determine their smoking rates. The names of all personnel working for the Mufti in Elazig province (population 510 000) were obtained, with all names being included in the study (n = 969). An anonymous, self-administered questionnaire was sent to them. Responses were received from 366 (98.9%) of the 370 provincial centre employees, and from 424 (70.8%) of the 599 employees working in the districts and villages. Standard questions used in the classification of smoking status in the United States,1questions recommended by Prochaska and colleagues to identify stages of change,2 3 and the Fagerström nicotine dependence test questions4 were used. Of the respondents, 780 (98.7%) were male and 749 (94.8%) were religious professionals. Of 10 women, three were current smokers; because of small numbers, women were not included in the analysis.
The prevalence of current smokers was 41.1% among religious professionals and 64.1% among other personnel (χ2 = 8.035, df = 1, p = 0.0046). This rate of current smoking among religious professionals also appeared to be substantially lower than that reported for men in Elazig, which has been found in different surveys to range from 53% to 77%.5-9 The rates of never-smoking were 38.7% among the religious professionals and 12.8% among the other employees (χ2 = 10.624, df = 1, p = 0.0011).
The impacts of age and educational status were only analysed for the male religious professionals. Within this group, rates of current smoking varied significantly by age: the higher the age, the lower the prevalence of smoking (χ2 = 16.132, df = 3, p = 0.0011). The rate of never-smoking was 30.4% among the group less than 30 years of age, which was significantly lower than that among older age groups (χ2 = 10.185, df = 3, p = 0.0171). The quit ratio (former smokers/ever-smokers) was also higher among the older age groups (χ2 = 10.408, df = 3, p = 0.0154).
The quit ratios indirectly standardised by age (ISBA) were 49.0% among the university graduates and 30.3% among others(p = 0.0028 by the Cochran test10). The rates of never-smoking ISBA were 38.2% for the university graduates and 38.8% for others. Current smoking rates indirectly standardised by age and educational status were 41.3% for the provincial centre and 40.9% for the districts and villages.
Among the smokers, 31.9% were in the precontemplation stage, 38.8% in the contemplation stage, and 29.3% in the preparation stage. The proportion of smokers who were in the precontemplation stage was substantially lower in this study than in other studies conducted among adult males in Elazig.5 7 The average Fagerström Dependence Score was 2.83 (standard deviation = 2.37) for all smokers.
We conclude that the religious profession protects its practitioners from starting to smoke, and that most smokers among them are willing to quit. Educational activities on tobacco control and quit-smoking campaigns directed at this group may work very well in Elazig and probably in most places in Turkey. This might also have an important impact on smoking in the population because of the influential roles played by religious professionals.
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