title: Smoking Cessation Counseling in Family Medicine: Changing Patient Perceptions.
abstract: BACKGROUND
  Tobacco use causes significant morbidity and mortality. Although studies show that people who smoke cigarettes are more likely to quit when health care providers recommend cessation, many patients may not perceive that advice was given.
  
  
  OBJECTIVE
  Using a survey, to determine if a provider visual cue improves patient perception that smoking cessation counseling occurred. Another objective is to evaluate effects on frequency of specific counseling elements.
  
  
  METHODS
  This was a quasi-experimental intervention study with a pre-post test design. The intervention was a quitline reference card attached to the billing form as a prompt for providers to address smoking cessation. The patient survey included 6 elements, each assigned 1 point. The outcomes were the mean survey summary score preintervention compared to postintervention and the distribution of individual elements.
  
  
  RESULTS
  Preintervention, 40 patients who smoke cigarettes completed the survey; 46 patients were enrolled postintervention. The groups were similar, with no significant differences in age, gender, or race/ethnicity. Mean survey summary scores pre- and postintervention were 4.1 and 5.1, respectively (P < .05). Compared with preintervention, more patients perceived the recommendation for a smoking cessation course postintervention (40% vs 83%, P < .05). No significant differences in perceptions of other counseling elements were found.
  
  
  CONCLUSIONS
  Providing a visual cue such as a quitline card is an effective and inexpensive means of prompting a provider to discuss smoking cessation and can be easily integrated into practice. Our results indicate that this strategy improves patient perceptions of counseling with potential to improve community health through education.
authors.affiliation: University of South Florida-Morton Plant Mease Family Medicine Residency Program, Dr. Joseph A. Eaddy Family Medicine Research Center, Clearwater, FL, USA tracy.johns@baycare.org.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Johns
authors.affiliation: Tampa General Medical Group, Tampa, FL, USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Metzger
authors.affiliation: University of South Florida-Morton Plant Mease Family Medicine Residency Program, Dr. Joseph A. Eaddy Family Medicine Research Center, Clearwater, FL, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lawrence
mesh_terms: D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010465:Perception; D011446:Prospective Studies; D016540:Smoking Cessation / Q000379:methods*
keywords: counseling; enablers; patient perceptions; primary care; smoking cessation