Smoking-related attitudes and clinical practices of medical personnel in Minnesota.
BACKGROUND
Effective clinic-based, smoking-cessation activities are not widely implemented.


OBJECTIVE
To compare and contrast the smoking-cessation attitudes and clinical practices of five types of primary healthcare team members.


METHODS
From July to October 2002, a cross-sectional survey was mailed to randomly selected primary care physicians (MDs), advanced practice nurses (APRNs), registered nurses (RNs), licensed practical nurses (LPNs), and medical assistants (MAs).


METHODS
Factors associated with limited smoking-cessation service delivery.


RESULTS
The overall response rate was 68% (n =3021). Most respondents reported that patients' smoking status was consistently documented at their clinic (79%); other system prompts were less common (30%). Many respondents reported documenting smoking status or recommending quitting; few reported consistently assessing, assisting, or arranging follow-up. The mean rank of smoking cessation as an important preventive service among nine preventive services declined from MDs (1.9) to APRNs (2.5), RNs (3.4), LPNs (4.2), and MAs (4.6). Smoking prevalence increased from 1% in MDs to 3% APRNs, 9% RNs, 17% LPNs, and 22% MAs. Those who reported no consistent smoking-cessation service delivery were more likely to be RNs, LPNs, or MAs, currently smoke, and work more hours. They were less likely to consider patients receptive to cessation messages, to consider themselves qualified to counsel on smoking, or to work in clinics that had smoking-cessation guidelines or system prompts such as chart reminders.


CONCLUSIONS
Smoking-cessation service delivery may be enhanced if educational offerings, system changes, and training include all clinical staff members.
Health Research Center, Park Nicollet Institute, Minneapolis, Minnesota 55416, USA. braunb@parknicollet.com
Barbara L
BL
Braun
Jinnet B
JB
Fowles
Leif I
LI
Solberg
Elizabeth A
EA
Kind
Harry
H
Lando
Donald
D
Pine
D000328:Adult; D000554:Ambulatory Care Facilities; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009740:Nursing Staff / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires