Smoking cessation counseling by primary care women physicians: Women Physicians' Health Study.
OBJECTIVE
The Women Physicians' Health Study (WPHS) offers a unique opportunity to examine the counseling and screening practices of women physicians. The objectives of this study were to: describe the prevalence of self-reported smoking cessation counseling among primary care women physicians and determine the association between physician demographic, professional, and personal characteristics and smoking cessation counseling.


METHODS
Conducted in 1993-1994, WPHS is a nationally representative cross-sectional mailed survey of U.S. women physicians and included 4,501 respondents representing all major specialties. Primary care physicians included 5 specialty areas and were grouped into 3 categories: (1) general primary care; (2) obstetrics/gynecology (ob/gyn); and (3) pediatrics. Frequent counseling was defined as having counseled patients who were known smokers at every visit or at least once a year.


RESULTS
Women physicians in general primary care (84%) and ob/gyn (83%) were more likely to frequently counsel their patients about cessation than were pediatricians (41%). Perceived relevance of counseling to a physician's practice was significantly associated with frequent counseling. Personal characteristics (current smoking status, personal or family history of a smoking-related disease, or living with a smoker as an adult or child) were not significantly correlated with counseling.


CONCLUSIONS
The majority (71%) of physicians reported frequently counseling their patients. However, there was significant variation by physician specialty. In addition, perceived relevance of counseling was strongly associated with counseling behavior. Physician counseling on cessation can reduce tobacco-related morbidity and mortality. Increasing perceived relevance, implementing system changes, and creating accountability can facilitate cessation counseling by physicians.
Easton
A
A
Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. ace7@cdc.gov
Husten
C
C
Malarcher
A
A
Elon
L
L
Caraballo
R
R
Ahluwalia
I
I
Frank
E
E
D000328:Adult; D000368:Aged; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006176:Gynecology; D019538:Health Care Surveys; D006801:Humans; D007388:Internal Medicine; D008511:Medicine / Q000706:statistics & numerical data*; D008875:Middle Aged; D009774:Obstetrics; D010372:Pediatrics; D010822:Physicians, Women / Q000145:classification / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011364:Professional Practice / Q000706:statistics & numerical data; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D013038:Specialization; D014481:United States; D000078329:Workforce