Physicians and smoking cessation. A survey of office procedures and practices in the Community Intervention Trial for Smoking Cessation
E. A. Lindsay, J. K. Ockene, N. Hymowitz, C. Giffen, L. Berger and P. Pomrehn
Community Health Research Unit, University of Ottawa, Ontario.
OBJECTIVE: To obtain a baseline measure of tobacco control activities
carried out by physicians and of tobacco control policies and practices in
physician offices. DESIGN: All primary care physicians in 11 communities
were asked through a mail survey about their tobacco control practices.
Thirty offices in each community were randomly selected and interviewed by
telephone to determine office policies and practices. SETTING: Both surveys
assessed primary care settings in the 11 intervention communities. RESULTS:
The physicians' survey (response rate, 48%) indicated that physicians
report intervention with smokers more than 70% of the time, but the
interventions rarely include key behavioral elements necessary for smoking
modification. Physicians who received formal training in smoking cessation
reported that they believed themselves to be more prepared and that they
spent more time counseling patients than physicians who were not trained.
The office survey (response rate, 83.2%) indicated that smoke-free policies
are in place in most clinics and offices and that many offices provide
printed materials on smoking cessation. However, few offices had staff to
coordinate smoking cessation activities. These surveys will be repeated
following the intervention phase of the Community Intervention Trial for
Smoking Cessation to assess changes in counseling practices and office
policies. CONCLUSION: There is a positive relationship between attending
training and intervening with more cessation activities. Physicians
perceive themselves as prepared to help smokers, but few are providing more
than advice to stop smoking.
