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Is smoking behaviour in patients with coronary heart disease influenced by whether their attending physician smokes?

Objective -To examine the association between the smoking status of attending physicians and that of their patients. Setting - Cardiology division of the Toyama Medical and Pharmaceutical University Hospital and two affiliated hospitals in Toyama District, Japan. Subjects -A total of 259 patients with known ischaemic heart disease who con sulted our outpatient clinic in September 1992, and their attending physicians at the clinic (n = 17). Thirty eight attending physicians who cared for 100 of these patients during a previous admission of the University Hospital were also in cluded in the study. Design and main outcome measures Smoking status of patients was deter mined by urinary cotinine radioimmuno assay using 125I-cotinine. Patients with urinary cotinine concentration above 50 ng/ml were classified as smokers. Smoking status of physicians was de termined by self report. Results - Smoking was found to be sig nificantly more prevalent (p < 0.05) in outpatients whose attending physicians smoked (20/94, 21.3%) than in those with