title: Smoking cessation counseling by surgical and nonsurgical residents: opportunities for health promotion education.
abstract: BACKGROUND
  Cigarette smoking is the leading cause of preventable death in North America and a major contributor to surgically treated diseases and operative complications. Counseling by residents can be an effective means of helping patients to quit smoking, and with the introduction of the Accreditation Council for Graduate Medical Education and CanMEDS competency frameworks, health promotion is a required component of residency training. However, past studies have found that smoking cessation counseling by residents, and in particular surgical residents, is lacking. In light of the introduction of health promotion as a core competency in residency training, this study was designed to examine the attitudes and practices of residents at our institution regarding smoking cessation counseling, comparing surgical and nonsurgical residents and seeking to identify barriers to resident counseling.
  
  
  METHODS
  An internet-based questionnaire was distributed to all residents at the University of Alberta in the fall of 2012. Items examined residents׳ attitudes and practices related to smoking cessation counseling and barriers to counseling.
  
  
  RESULTS
  Although almost all residents believed that smoking cessation was important and that counseling was part of their job as a resident, far fewer routinely practiced the counseling behaviors examined. Surgical residents were less likely to perform counseling and more likely to think that counseling was not part of their job. Surgical residents were also more likely to identify obstacles to counseling such as a lack of time and formal training.
  
  
  CONCLUSIONS
  Residents, and surgical residents in particular, are missing opportunities to help their patients quit smoking and improve their health. Given their positive attitudes toward counseling, it may be possible to improve their counseling practices through simple means. By identifying obstacles to counseling and tools that may increase residents׳ tendency to perform counseling, this study can help to guide training programs aimed at improving resident competency in health promotion.
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Simon R
authors.initials: SR
authors.lastname: Turner
authors.affiliation: Department of Undergraduate Medical Education, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Hollis
authors.initials: H
authors.lastname: Lai
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, Alberta, Canada. Electronic address: elbedard@gmail.com.
authors.forename: Eric L R
authors.initials: EL
authors.lastname: Bédard
mesh_terms: D000416:Alberta; D003376:Counseling; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D020407:Internet; D007396:Internship and Residency; D016540:Smoking Cessation; D011795:Surveys and Questionnaires
keywords: Interpersonal and Communication Skills; Patient Care; Professionalism; competence; professional; public advocacy; residency; smoking; tobacco