Top

BMC Primary Care

Published in:

Open Access 01-12-2009 | Research article

Self-reported smoking cessation activities among Swiss primary care physicians

Authors: Isabelle Jacot Sadowski, Christiane Ruffieux, Jacques Cornuz

Published in: BMC Primary Care | Issue 1/2009

Abstract

Background

Individual counselling, pharmacotherapy, and group therapy are evidence-based interventions that help patients stop smoking. Acupuncture, hypnosis, and relaxation have no demonstrated efficacy on smoking cessation, whereas self-help material may only have a small benefit. The purpose of this study is to assess physicians' current clinical practice regarding smokers motivated to stop smoking.

Methods

The survey included 3385 Swiss primary care physicians. Self-reported use of nine smoking cessation interventions was scored. One point was given for each positive answer about practicing interventions with demonstrated efficacy, i.e. nicotine replacement therapy, bupropion, counselling, group therapy, and smoking cessation specialist. No points were given for the recommendation of acupuncture, hypnosis, relaxation, and self-help material. Multivariable logistic analysis was performed to identify factors associated with a good practice score, defined as ≥ 2.

Results

The response rate was 55%. Respondents were predominately over the age of 40 years (88%), male (79%), and resided in urban areas (74%). Seventeen percent reported being smokers. Most of the physicians prescribed nicotine replacement therapy (84%), bupropion (65%), or provided counselling (70%). A minority of physicians recommended acupuncture (26%), hypnosis (8%), relaxation (7%), or self-help material (24%). A good practice score was obtained by 85% of respondents. Having attended a smoking cessation-training program was the only significant predictor of a good practice score (odds ratio: 6.24, 95% CI 1.95–20.04).

Conclusion

The majority of respondents practice recommended smoking cessation interventions. However, there is room for improvement and implementing an evidence-based smoking cessation-training program could provide additional benefit.

Available only for authorised users

Stead LF, Bergson G, Lancaster T: Physician advice for smoking cessation. Cochrane Database Syst Rev. 2008, Article Nr.: CD000165-10.1002/14651858.CD000165.pub3. 2

Fiore MC, Jaen CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, Dorfman SF, Froelicher ES, Goldstein MG, Healton CG, Nez Henderson P, Heyman RB, Koh HK, Kottke TE, Lando HA, Mecklenburg RE, Mermelstein RJ, Dolan Mullen P, Orleans CT, Robinson L, Stitzer ML, Tommasello AC, Villejo L, Wewers ME: Treating Tobacco Use and Dependence: Clinical Practice Guideline. 2008 Update. 2008, Agency for Health Care Policy and Research, Public Health Service, US Dept of Health and Human Services, [http://www.ahrq.gov/path/tobacco.htm#Clinic]

Stead LF, Perera R, Bullen C, Mant D, Lancaster T: Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2008, Art. Nr.: CD000146-10.1002/14651858.CD000146.pub3. 1

Hughes JR, Stead LF, Lancaster T: Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2007, Art. Nr.: CD000031-10.1002/14651858.CD000031.pub3. , 1

Stead LF, Lancaster T: Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2005, Art. Nr.: CD001007-10.1002/14651858.CD001007.pub2. 2

White AR, Rampes H, Campbell JL: Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2006, Art. Nr.: CD000009-10.1002/14651858.CD000009.pub2. 1

Abbot NC, Stead LF, White AR, Barnes J: Hypnotherapy for smoking cessation. Cochrane Database Syst Rev. 1998, Art. Nr.: CD001008-10.1002/14651858.CD001008. 2

Lancaster T, Stead LF: Self-help interventions for smoking cessation. Cochrane Database Syst Rev. 2005, Art. Nr.: CD001118-10.1002/14651858.CD001118.pub2. 3

Swiss Federal Office of Statistics: Enquête suisse sur la santé 2002 (Swiss Health Survey 2002). 2003, Neuchâtel; Swiss Federal Office of Statistics

10.

Humair JP, Sanchez-Menegez C, Stalder H: Prévention par les médecins de premier recours à Genève: Attitudes, habitudes personnelles et pratiques cliniques (Primary care physicians and prevention in Geneva: Attitudes, personal health behaviour and clinical practice). Zurich; Assemblée Annuelle de la Société Suisse de Médecine Interne. 1996

11.

Conroy MB, Majchrzak NE, Regan S, Silverman CB, Schneider LI, Rigotti NA: The association between patient-reported receipt of tobacco intervention at a primary care visit and the smokers' satisfaction with their health care. Nicotine Tob Res. 2005, 7: S29-S34. 10.1080/14622200500078063.CrossRefPubMed

12.

Cornuz J, Pinget C, Gilbert A, Paccaud F: Cost-effectiveness analysis of the first-line therapies for nicotine dependence. Eur J Clin Pharmacol. 2003, 59: 201-206. 10.1007/s00228-003-0610-6.CrossRefPubMed

13.

Cornuz J, Ghali WA, Di Carlantonio D, Pecoud A, Paccaud F: Physicians' attitudes towards prevention: importance of intervention-specific barriers and physicians' health habits. Fam Pract. 2000, 17: 535-540. 10.1093/fampra/17.6.535.CrossRefPubMed

14.

Vogt F, Hall S, Marteau TM: General practitioners' and family physicians' negative beliefs and attitudes toward discussing smoking cessation with patients: a systematic review. Addiction. 2005, 100: 1423-1431. 10.1111/j.1360-0443.2005.01221.x.CrossRefPubMed

15.

McEwen A, West R, Preston A: Triggering anti-smoking advice by GPs: Mode of action of an intervention stimulating smoking cessation advice by GPs. Patient Educ Couns. 2006, 62: 89-94. 10.1016/j.pec.2005.06.008.CrossRefPubMed

16.

Wynn A, Coleman T, Barrett S, Wilson A: Factors associated with the provision of anti-smoking advice in general practice consultations. Br J Gen Pract. 2002, 52: 997-999.PubMedPubMedCentral

17.

Eckert T, Junker C: Motivation for smoking cessation: what role do doctors play?. Swiss Med Wkly. 2001, 131: 521-526.PubMed

18.

Krebs H, Keller R, Hornung R: Prise en charge médicale des fumeurs en Suisse: opinion des fumeurs et anciens fumeurs. Résumé du rapport de recherche 2003. Monitorage sur le tabac – Enquête suisse sur le tabagisme. 2006, (Physicians'clinical practice toward smokers in Switzerland: smokers and ex-smokers opinion. Swiss Tobacco Monitoring Survey). Universität Zürich

19.

Humair JP, Cornuz J: A new curriculum using active learning methods and standardized patients to train residents in smoking cessation. J Gen Intern Med. 2003, 18: 1023-1027. 10.1111/j.1525-1497.2003.20732.x.CrossRefPubMedPubMedCentral

20.

Steptoe A, Doherty S, Kendrick T, Rink E, Hilton S: Attitudes to cardiovascular health promotion among GPs and practice nurses. Fam Prac. 1999, 16: 158-163. 10.1093/fampra/16.2.158.CrossRef

21.

Brotons C, Björkelund C, Bulc M, Ciurana R, Godycki-Cwirko M, Jurgova E, Kloppe P, Lionis C, Mierzecki A, Pineiro R, Pullerits L, Sammut MR, Sheehan M, Tataradze R, Thireos EA, Vuchak J, EUROPREV Network: Prevention and health promotion in clinical practice: the views of general practitioners in Europe. Prev Med. 2005, 40: 595-601. 10.1016/j.ypmed.2004.07.020.CrossRefPubMed

22.

Ward MM, Vaughn TE, Uden-Holman T, Doebbeling BN, Clarke WR, Woolson RF: Physician knowledge, attitudes and practices regarding a widely implemented guideline. J Eval Clin Pract. 2002, 8: 155-162. 10.1046/j.1365-2753.2002.00337.x.CrossRefPubMed

23.

Kotz D, Wagena EJ, Wesseling G: Smoking cessation practices of Dutch general practitioners, cardiologists, and lung physicians. Respir Med. 2007, 3: 568-573. 10.1016/j.rmed.2006.06.016.CrossRef

24.

Young JM, Ward JE: Implementing guidelines for smoking cessation advice in Australian general practice: opinions, current practices, readiness to change and perceived barriers. Fam Pract. 2001, 18: 14-20. 10.1093/fampra/18.1.14.CrossRefPubMed

25.

McIlvain HE, Backer EL, Crabtree BF, Lacy N: Physician attitude and the Use of office-based activities for tobacco control. Fam Med. 2002, 34: 114-119.PubMed

26.

Sebo P, Bouvier Gallacchi M, Goehring C, Kunzi B, Bovier PA: Use of tobacco and alcohol by Swiss primary care physicians: a cross-sectional survey. BMC Public Health. 2007, 12;7: 5-10.1186/1471-2458-7-5.CrossRef

27.

Cornuz J, Humair JP, Seematter L, Stoianov R, van Melle G, Stalder H, Pecoud A: Efficacy of resident training in smoking cessation: a randomized controlled trial of a program based on application of behavioral therapy and practice with standardized patients. Ann Intern Med. 2002, 136: 429-37.CrossRefPubMed

28.

Cornuz J, Humair JP, Zellweger JP: Désaccoutumance au tabac. 1ère partie: Processus de désaccoutumance et bénéfices de l'arrêt (Smoking cessation: Swiss clinical recommendations). Schweiz Med Forum. 2004, 4: 334-339.

29.

Cornuz J, Humair JP, Zellweger JP: Désaccoutumance au tabac. 2ème partie: Recommandations pour la pratique clinique (Smoking cessation: Swiss clinical recommendations). Schweiz Med Forum. 2004, 4: 356-368.

30.

Frei von Tabak. [http://www.frei-von-tabak.ch]

31.

Frei von Tabak. [http://www.vivre-sans-tabac.ch]

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2296/10/22/prepub

Title: Self-reported smoking cessation activities among Swiss primary care physicians
Authors: Isabelle Jacot Sadowski
Christiane Ruffieux
Jacques Cornuz
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: BMC Primary Care / Issue 1/2009
Electronic ISSN: 2731-4553
DOI: https://doi.org/10.1186/1471-2296-10-22

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Self-reported smoking cessation activities among Swiss primary care physicians

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2009

Factors prompting PSA-testing of asymptomatic men in a country with no guidelines: a national survey of general practitioners

Research activity and capacity in primary healthcare: The REACH study: A survey

Evaluation of prescribing patterns in a German network of CAM physicians for the treatment of patients with hypertension: a prospective observational study

Effects of self-monitoring of glucose in non-insulin treated patients with type 2 diabetes: design of the IN CONTROL-trial

Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study

The GP Patient Survey for use in primary care in the National Health Service in the UK – development and psychometric characteristics