Training physicians about smoking cessation: a controlled trial in private practice.
OBJECTIVE
To test the hypotheses that physicians in private practice who receive a continuing education program (entitled "Quit for Life") about how to counsel smokers to quit would counsel smokers more effectively and have higher rates of long-term smoking cessation among their patients.


METHODS
Randomized trial with blinded assessment of principal outcomes.


METHODS
Private practices of internal medicine and family practice.


METHODS
Forty-four physicians randomly assigned to receive training (24) or serve as controls (20) and consecutive samples of smokers visiting each physician (19.6 patients per experimental and 22.3 per control physician).


METHODS
Physicians received three hours of training about how to help smokers quit. Physicians and their office staffs were also given self-help booklets to distribute to smokers and were urged to use a system of stickers on charts as reminders to counsel smokers about quitting.


RESULTS
Based on telephone interviews with patients, physicians in the experimental group were more likely to discuss smoking with patients who smoked (64% vs. 44%), spent more time counseling smokers about quitting (7.5 vs. 5.2 minutes), helped more smokers set dates to quit smoking (29% vs. 5% of smokers), gave out more self-help booklets (37% vs. 9%), and were more likely to make a follow-up appointment about quitting smoking (19% vs. 11% of those counseled) than physicians in the control group. One year later, the rates of biochemically confirmed, long-term (greater than or equal to 9 months) abstinence from smoking were similar among patients in the experimental (3.2%) and control (2.5%) groups (95% confidence interval for the 0.7% difference: -1.7 to +3.1%).


CONCLUSIONS
The authors conclude that this continuing education program substantially changed the way physicians counseled smokers, but had little or no impact on rates of long-term smoking cessation among their patients. There is a need for more effective strategies to help physicians help their patients to quit smoking.
Cummings
S R
SR
Division of General Internal Medicine, University of California, San Francisco 94143-0320.
Richard
R J
RJ
Duncan
C L
CL
Hansen
B
B
Vander Martin
R
R
Gerbert
B
B
Coates
T J
TJ
D002983:Clinical Competence / Q000592:standards; D003376:Counseling / Q000592:standards*; D004502:Education, Medical, Continuing / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010353:Patient Education as Topic / Q000592:standards*; D010817:Physician-Patient Relations; D011331:Private Practice / Q000592:standards*; D016032:Randomized Controlled Trials as Topic; D000074606:Smoking Prevention