Frequency of physician-directed assistance for smoking cessation in patients receiving cessation medications.
BACKGROUND
Little is known about current physician-patient interactions regarding smoking cessation when a prescription is given for cessation medications.


METHODS
We identified 1360 health plan members who were smokers and had filled prescriptions for bupropion hydrochloride or nicotine replacement products from March 26, 2002, through April 8, 2003. These members were surveyed 3 months after the order was filled to learn about the physician encounter that produced these prescriptions and the role of the physician in selecting the medication, supporting cessation, and achieving desirable outcomes.


RESULTS
Among the 1035 eligible complete responses (adjusted response rate, 78%), only 36.4% reported being asked to set a specific quit date; 25.3%, to use cessation counseling; and 23.3%, to have any type of follow-up. The only physician action associated with the use of the medication was asking to set a quit date (90.7% vs 83.5%; P = .001) and no action was significantly associated with cessation. Smokers with tobacco-related chronic conditions were more likely to report physician influence but less likely to report receiving information on using the quit aid (60.6% vs 66.5%; P = .048) or being asked to set a quit date (31.7% vs 41.4%; P = .001).


CONCLUSIONS
Despite the evidence-based guideline recommendations for more support for cessation, physician support actions for those receiving prescriptions appear to be relatively infrequent and to have little influence on the use of medication by smokers or on their smoking cessation. Other environmental changes may be needed to facilitate more thorough support.
Solberg
Leif I
LI
HealthPartners and HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA. leif.i.solberg@healthpartners.com
Asche
Stephen E
SE
Boyle
Raymond G
RG
Boucher
Jackie L
JL
Pronk
Nicolaas P
NP
D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003376:Counseling; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires
D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion