Impact of patient characteristics on physician's smoking cessation strategies.
BACKGROUND
The effectiveness of smoking cessation interventions may be influenced by a variety of patient characteristics, including level of nicotine addiction and readiness to change. We conducted this study to examine the relationship between these characteristics and the frequency of physician-initiated smoking cessation interventions.


METHODS
We identified smokers seen during office visits to 1 of 38 primary care physicians in rural Kansas. Trained students observed the frequency and nature of doctor-patient discussions related to tobacco. Telephone surveys were conducted with these patients 1 to 3 days after the office visit.


RESULTS
We completed observations and telephone surveys on 259 smokers. Tobacco-related discussions occurred during 66% of doctor-patient encounters. Although discussions overall were unrelated to a patient's readiness to quit, specific assistance with smoking cessation was offered less often to precontemplators (15%) than to contemplators (31%) or those preparing to quit (37%) (P < 0.05). While bupropion was discussed with 23% of smokers, nicotine replacement therapy was discussed with 12% and was unrelated to markers of nicotine addiction.


CONCLUSIONS
Current efforts to promote smoking cessation are only marginally related to patient characteristics. Doctors are missing many opportunities to effectively intervene with patients who are contemplating smoking cessation or preparing to quit.
Ellerbeck
Edward F
EF
Department of Preventive Medicine, University of Kansas School of Medicine, Kansas City, KS 66160-7313, USA. eellerbe@kumc.edu
Choi
Won S
WS
McCarter
Kevin
K
Jolicoeur
Denise G
DG
Greiner
Allen
A
Ahluwalia
Jasjit S
JS
D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D005194:Family Practice / Q000193:education; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D007615:Kansas / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D013337:Students, Medical