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Physicians discuss the risks of smoking with their patients, but seldom offer practical cessation support.

Keto J, Jokelainen J, Timonen M, Linden K, Ylisaukko-oja T - Subst Abuse Treat Prev Policy (2015)

Bottom Line: The respondents were more active in discussing smoking with their patients than in offering practical cessation help.Physicians offer their patients practical cessation support relatively infrequently.Secondary care physicians should acknowledge the authority they pose toward smoking patients.

View Article: PubMed Central - PubMed

Affiliation: Department of General Medicine, Faculty of Medicine, University of Oulu, P.O. Box 5000, FIN-90014, Oulu, Finland. jaana.keto@helsinki.fi.

ABSTRACT

Background: Our aim was to study the smoking cessation-related 1) attitudes & experiences and 2) consultation practices of Finnish physicians and to determine if there is a relationship between the two.

Methods: An online survey on smoking cessation was sent to 39 % of all Finnish physicians, with emphasis on physicians working in fields relevant to smoking cessation. A total of 1141 physicians (response rate 15 %) responded to the online survey, 53 % of whom were employed in primary health care. A total of 1066 respondents were eligible for the analysis. The questionnaire included questions on the physician's own smoking status, their attitudes and experiences on smoking cessation, and the implementation of smoking cessation in clinical practice. Two sub-scales concerning smoking-related consultation activities were constructed: one for conversation, and another for practical actions.

Results: The most common consultation activities (respondents who reported doing the following actions "nearly always") were asking how much the patient smokes (65 %), marking smoking status in patient records (58 %) and recommending quitting to the patient (55 %). The least common activity was prescribing withdrawal medication (4 %). Primary care physicians were more active than those working in secondary health care in nearly all activities mapped. A positive attitude and experiences on smoking cessation were associated with actively offering withdrawal support. Those who were familiar with the local treatment guidelines for tobacco addiction were 30 % more active in offering practical cessation help to their patient. The respondents were more active in discussing smoking with their patients than in offering practical cessation help.

Conclusion: Physicians offer their patients practical cessation support relatively infrequently. Practical cessation calls for continuous education of physicians about the nature of tobacco and nicotine addiction, the role of smoking as a risk factor for various diseases, and the practical measures needed for smoking cessation. Secondary care physicians should acknowledge the authority they pose toward smoking patients.

No MeSH data available.


Related in: MedlinePlus

Smoking cessation help offered by Finnish physicians. Percentages of respondents who reported taking the following actions “nearly always”. n = 1066, df = 1 for all items, * = p < 0.05 (χ2 test)
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Fig1: Smoking cessation help offered by Finnish physicians. Percentages of respondents who reported taking the following actions “nearly always”. n = 1066, df = 1 for all items, * = p < 0.05 (χ2 test)

Mentions: The questions on consultation activities were chosen from the well-known study by Pipe and colleagues to allow international comparison [7]. The activities were also in line with local clinical guidelines for smoking cessation [5]. There were a total of 10 items, for which a four-point grading system was applied: “nearly always” (3), “often” (2), “sometimes,” (1) and “never” (0). The consultation items were divided into two categories based on statistical and content-related analysis: conversation and practical actions. “Conversation” covered behavior that acts as a mini intervention; sending the patient a message that smoking is something the physician is deeply concerned about. “Practical actions” covered items that make it easier for the patient to quit once they have made the decision to do so, such as helping the patient make a quitting plan or offering pharmaceutical cessation aid. Pharmaceutical aid can be either over-the-counter nicotine replacement therapy or prescription medication (bupropion, varenicline, nortriptyline). These activities are listed in Fig. 1. The scores gained in the consultation sub-scales were utilized when searching for an association between consultation activities and smoking-related attitudes and experiences.Fig. 1


Physicians discuss the risks of smoking with their patients, but seldom offer practical cessation support.

Keto J, Jokelainen J, Timonen M, Linden K, Ylisaukko-oja T - Subst Abuse Treat Prev Policy (2015)

Smoking cessation help offered by Finnish physicians. Percentages of respondents who reported taking the following actions “nearly always”. n = 1066, df = 1 for all items, * = p < 0.05 (χ2 test)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4630922&req=5

Fig1: Smoking cessation help offered by Finnish physicians. Percentages of respondents who reported taking the following actions “nearly always”. n = 1066, df = 1 for all items, * = p < 0.05 (χ2 test)
Mentions: The questions on consultation activities were chosen from the well-known study by Pipe and colleagues to allow international comparison [7]. The activities were also in line with local clinical guidelines for smoking cessation [5]. There were a total of 10 items, for which a four-point grading system was applied: “nearly always” (3), “often” (2), “sometimes,” (1) and “never” (0). The consultation items were divided into two categories based on statistical and content-related analysis: conversation and practical actions. “Conversation” covered behavior that acts as a mini intervention; sending the patient a message that smoking is something the physician is deeply concerned about. “Practical actions” covered items that make it easier for the patient to quit once they have made the decision to do so, such as helping the patient make a quitting plan or offering pharmaceutical cessation aid. Pharmaceutical aid can be either over-the-counter nicotine replacement therapy or prescription medication (bupropion, varenicline, nortriptyline). These activities are listed in Fig. 1. The scores gained in the consultation sub-scales were utilized when searching for an association between consultation activities and smoking-related attitudes and experiences.Fig. 1

Bottom Line: The respondents were more active in discussing smoking with their patients than in offering practical cessation help.Physicians offer their patients practical cessation support relatively infrequently.Secondary care physicians should acknowledge the authority they pose toward smoking patients.

View Article: PubMed Central - PubMed

Affiliation: Department of General Medicine, Faculty of Medicine, University of Oulu, P.O. Box 5000, FIN-90014, Oulu, Finland. jaana.keto@helsinki.fi.

ABSTRACT

Background: Our aim was to study the smoking cessation-related 1) attitudes & experiences and 2) consultation practices of Finnish physicians and to determine if there is a relationship between the two.

Methods: An online survey on smoking cessation was sent to 39 % of all Finnish physicians, with emphasis on physicians working in fields relevant to smoking cessation. A total of 1141 physicians (response rate 15 %) responded to the online survey, 53 % of whom were employed in primary health care. A total of 1066 respondents were eligible for the analysis. The questionnaire included questions on the physician's own smoking status, their attitudes and experiences on smoking cessation, and the implementation of smoking cessation in clinical practice. Two sub-scales concerning smoking-related consultation activities were constructed: one for conversation, and another for practical actions.

Results: The most common consultation activities (respondents who reported doing the following actions "nearly always") were asking how much the patient smokes (65 %), marking smoking status in patient records (58 %) and recommending quitting to the patient (55 %). The least common activity was prescribing withdrawal medication (4 %). Primary care physicians were more active than those working in secondary health care in nearly all activities mapped. A positive attitude and experiences on smoking cessation were associated with actively offering withdrawal support. Those who were familiar with the local treatment guidelines for tobacco addiction were 30 % more active in offering practical cessation help to their patient. The respondents were more active in discussing smoking with their patients than in offering practical cessation help.

Conclusion: Physicians offer their patients practical cessation support relatively infrequently. Practical cessation calls for continuous education of physicians about the nature of tobacco and nicotine addiction, the role of smoking as a risk factor for various diseases, and the practical measures needed for smoking cessation. Secondary care physicians should acknowledge the authority they pose toward smoking patients.

No MeSH data available.


Related in: MedlinePlus