title: Does smoking status affect the likelihood of consulting a doctor about respiratory symptoms? A pilot survey in Western Australia.
abstract: BACKGROUND
  Smokers attribute respiratory symptoms, even when severe, to everyday causes and not as indicative of ill-health warranting medical attention. The aim of this pilot study was to conduct a structured vignette survey of people attending general practice to determine when they would advise a person with respiratory symptoms to consult a medical practitioner. Particular reference was made to smoking status and lung cancer.
  
  
  METHODS
  Participants were recruited from two general practices in Western Australia. Respondents were invited to complete self-administered questionnaires containing nine vignettes chosen at random from a pool of sixty four vignettes, based on six clinical variables. Twenty eight vignettes described cases with at least 5% risk of cancer. For analysis these were dubbed 'cancer vignettes'. Respondents were asked if they would advise a significant other to consult a doctor with their respiratory symptoms. Logistic regression and non-parametric tests were used to analyse the data.
  
  
  RESULTS
  Three hundred questionnaires were distributed and one hundred and forty completed responses were collected over six weeks. The majority (70.3%) of respondents were female aged forty and older. A history of six weeks' of symptoms, weight loss, cough and breathlessness independently increased the odds of recommending a consultation with a medical practitioner by a factor of 11.8, 2.11, 1.40 and 4.77 respectively. A history of smoking independently increased the odds of the person being thought 'likely' or 'very likely' to have cancer by a factor of 2.46. However only 32% of cancer vignettes with a history of cigarette smoking were recognised as presentations of possible cancer.
  
  
  CONCLUSIONS
  Even though a history of cigarette smoking was more likely to lead to the suggestion that a symptomatic person may have cancer we did not confirm that smokers would be more likely to be advised to consult a doctor, even when presenting with common symptoms of lung cancer.
authors.affiliation: Western Australian Centre for Cancer and Palliative Care, Curtin University of Technology, Western Australia, Australia. m.jiwa@curtin.edu.au
authors.forename: Moyez
authors.initials: M
authors.lastname: Jiwa
authors.forename: Hayley
authors.initials: H
authors.lastname: Arnet
authors.forename: Georgia
authors.initials: G
authors.lastname: Halkett
authors.forename: Marthe
authors.initials: M
authors.lastname: Smith
authors.forename: Moira
authors.initials: M
authors.lastname: O'Connor
authors.forename: Julia
authors.initials: J
authors.lastname: Rhodes
authors.forename: Kate
authors.initials: K
authors.lastname: Poland
authors.forename: Max
authors.initials: M
authors.lastname: Bulsara
mesh_terms: D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D012120:Respiration Disorders / Q000175:diagnosis / Q000209:etiology; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014904:Western Australia