Smoking prevention counseling practices of Montreal general practitioners.
BACKGROUND
Primary care physicians are potentially important sources of interventions aimed at preventing youth smoking. Yet recent surveys suggest that physician smoking prevention practices are less than optimal.


OBJECTIVE
To document prevention counseling practices and to identify correlates of these activities in a random sample of general practitioners in Montreal, Quebec.


METHODS
A cross-sectional mail survey.


RESULTS
Of 440 eligible general practitioners (GPs), 337 (77%) completed the questionnaire. General practitioners were more likely to ascertain the smoking status of adolescents (70.9%) than preadolescents (35.7%). Although about half of the GPs offered advice to prevent smoking onset in young adults (48.6%) and adolescents (48.3%), fewer did so for preadolescents (34.4%); only 12.1% advised parents to discuss smoking onset with their children. Correlates of ascertaining smoking status included female sex (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.07-3.41), lower proportion of walk-in patients (OR, 2.73; 95% CI, 1.31-5.80), awareness of the "stage of behavior change" model (OR, 2.17; 95% CI, 1.18-4.04), and higher self-efficacy (OR, 4.12, 95% CI, 2.00-8.69). Correlates of provision of prevention advice included more hours spent in direct patient care (OR, 1.93; 95% CI, 1.13-3.34), favorable beliefs and attitudes (OR, 1.73; 95% CI, 1.06-2.83), and higher self-efficacy (OR, 4.32; 95% CI, 2.25-8.44).


CONCLUSIONS
Our results point to the need for renewed efforts to enhance preventive efforts in primary care settings. Intervention programs for GPs should emphasize overcoming unfavorable beliefs and attitudes and low self-efficacy. Future research should evaluate the effect of brief prevention counseling adapted to increasingly busy practices.
Makni
Héla
H
Direction de la Santé Publique de Montréal-Centre, Pavillon Lafontaine, 1301 Sherbrooke E, Montréal, Québec H2L 1M3. hmakni@santepub-mtl.qc.ca
O'Loughlin
Jennifer L
JL
Tremblay
Michèle
M
Gervais
André
A
Lacroix
Chantal
C
Déry
Véronique
V
Paradis
Gilles
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011792:Quebec; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires