title: Assessment of compliance with U.S. Public Health Service clinical practice guideline for tobacco by primary care physicians.
abstract: BACKGROUND
  The US Public Health Service clinical practice guideline treating tobacco use and dependence: 2008 update established an expanded standard of care, calling on physicians to consistently identify their patients who use tobacco and treat them using counseling and medication.
  
  
  RESULTS
  To assess compliance, we examined the extent to which physicians self-report following four of the five components of the 5A model: Ask about tobacco use, Advise patients who use tobacco to quit, Assist the patient in making a quit attempt, and Arrange for follow-up care. We used data from a Web-based panel survey administered to a convenience sample of 1,253 primary care providers (family/general practitioners, internists, and obstetrician/gynecologists). We found that 97.1% of the providers reported that they consistently Asked and documented tobacco use, while 98.6% reported that they consistently Advised their patients to quit using tobacco. Among the family/general practitioners and internists, 98.3% recommended "any" (medication, counseling, counseling and medication, telephone quitline) smoking cessation strategies (Assist). Among all providers, 48.0% reported that they consistently scheduled a follow-up visit (Arrange).
  
  
  CONCLUSIONS
  This study revealed that most primary care physicians reported that they Ask their patients about tobacco use, Advise them to quit, and Assist them in making a quit attempt, but only half reported that they Arrange a follow-up visit. Tobacco use screening and intervention are among the most effective clinical preventive services; thus, efforts to educate, encourage, and support primary care physicians to provide evidence-based treatments to their patients should be continued.
authors.affiliation: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, CDC4770 Buford Highway, Chamblee, Building 107, M/S, F-79, Atlanta, GA, 30341-3717, USA. jkruger@cdc.gov.
authors.forename: Judy
authors.initials: J
authors.lastname: Kruger
authors.affiliation: Contractor Support for NCCDPHP/NGIS, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, 30341-3717, USA. idg3@cdc.gov.
authors.forename: Alissa
authors.initials: A
authors.lastname: O'Halloran
authors.affiliation: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, CDC4770 Buford Highway, Chamblee, Building 107, M/S, F-79, Atlanta, GA, 30341-3717, USA. abbyrosenthal@bellsouth.net.|Health Systems Consulting, Atlanta, GA, 30341, USA. abbyrosenthal@bellsouth.net.
authors.forename: Abby
authors.initials: A
authors.lastname: Rosenthal
mesh_terms: D000328:Adult; D003376:Counseling / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D015980:Public Health Practice / Q000706:statistics & numerical data; D016540:Smoking Cessation / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000175:diagnosis* / Q000628:therapy*; D014481:United States; D014492:United States Public Health Service