title: Light smokers are less likely to receive advice to quit from their GP than moderate-to-heavy smokers: a comparison of national survey data from the Netherlands and England.
abstract: BACKGROUND
  A substantial proportion of smokers nowadays smoke fewer than 10 cigarettes per day (cpd). These 'light' smokers are still exposed to significant health risks but may not receive as much attention from health professionals as heavier smokers. The Netherlands and England are two countries with very different smoking cessation treatment climates and may vary in the extent to which GPs advise on smoking cessation.
  
  
  OBJECTIVE
  To assess whether Dutch and English light smokers (< 10 cpd) are less likely to receive advice to stop smoking during a consultation with their GP than moderate-to-heavy smokers (≥ 10 cpd).
  
  
  METHODS
  We compared data from two series of national surveys: the Dutch 'Continuous Survey of Smoking Habits' and the English 'Smoking Toolkit Study'. We included respondents to both surveys from February 2010 to December 2011, aged 16+ years, who consulted their GP in the previous 12 months.
  
  
  RESULTS
  A total of 7734 smokers responded to the surveys in the Netherlands and 10 383 in England. The percentage of Dutch smokers who received advice to quit from their GP was 22.6% (95% CI = 21.5-23.7) compared with 58.9% (95% CI = 57.6-60.2) of English smokers. Light smokers were less likely to receive advice to quit than moderate-to-heavy smokers, both in the Netherlands (OR = 0.57, 95% CI = 0.50-0.65) and in England (OR = 0.64, 95% CI = 0.57-0.72).
  
  
  CONCLUSIONS
  Smokers in the Netherlands are less than half as likely to receive advice to quit from their GP as smokers in England. In both countries, light smokers are less likely to receive advice to quit from their GP than moderate-to-heavy smokers.
authors.affiliation: Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands. d.kotz@maastrichtuniversity.nl
authors.forename: Daniel
authors.initials: D
authors.lastname: Kotz
authors.forename: Marc C
authors.initials: MC
authors.lastname: Willemsen
authors.forename: Jamie
authors.initials: J
authors.lastname: Brown
authors.forename: Robert
authors.initials: R
authors.lastname: West
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003625:Data Collection; D004739:England; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D055815:Young Adult