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Published in: BMC Primary Care 1/2007

Open Access 01-12-2007 | Research article

General practitioners' beliefs about effectiveness and intentions to recommend smoking cessation services: qualitative and quantitative studies

Authors: Florian Vogt, Sue Hall, Theresa M Marteau

Published in: BMC Primary Care | Issue 1/2007

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Abstract

Background

General practitioners' (GPs) negative beliefs about smoking cessation services may act as barriers to them recommending such services to smokers motivated to stop smoking.

Methods

In Study 1, 25 GPs from 16 practices across London were interviewed in this qualitative study. Framework analysis was used to identify key themes in GPs' beliefs about smoking cessation services. In Study 2, a convenience sample of 367 GPs completed an internet-based survey. Path-analysis was used to examine relationships between beliefs identified in Study 1 and intentions to recommend smoking cessation services.

Results

In Study 1, GPs felt that smoking cessation assistance was best provided by others. GPs favoured local services (i.e. practice nurses offering stop smoking support) over central services (i.e. offered through the Primary Care Trust), mainly because these were seen as more personalised and accessible for patients. These beliefs appeared to influence GPs' beliefs about the effectiveness of services. In Study 2, GPs' beliefs had a large effect on their intentions to recommend both central services, (f 2 = .79) and local services, (f 2 = 1.04). GPs' beliefs about effectiveness and cost-effectiveness were key predictors their intentions to recommend central services and local services. Beliefs about the level of personalisation offered and smokers' likelihood of attending services had indirect effects on intentions to recommend services operating via beliefs about effectiveness.

Conclusion

GPs vary in their perceptions of the effectiveness of smoking cessation services and their intentions to recommend these services vary in line with these beliefs. Interventions aimed at increasing the likelihood with which GPs recommend these services may therefore be more effective if they addressed these beliefs.
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Literature
1.
go back to reference Department of Health: Choosing Health: making healthier choices easier. 2004, The Stationary Office Department of Health: Choosing Health: making healthier choices easier. 2004, The Stationary Office
2.
3.
go back to reference Parrott S, Godfrey C: Economics of smoking cessation. Br Med J. 2004, 328 (7445): 947-949. 10.1136/bmj.328.7445.947.CrossRef Parrott S, Godfrey C: Economics of smoking cessation. Br Med J. 2004, 328 (7445): 947-949. 10.1136/bmj.328.7445.947.CrossRef
4.
go back to reference Ferguson J, Bauld L, Chesterman J, Judge K: The English smoking treatment services: one-year outcomes. Addiction. 2005, 100 (s2): 59-69. 10.1111/j.1360-0443.2005.01028.x.CrossRefPubMed Ferguson J, Bauld L, Chesterman J, Judge K: The English smoking treatment services: one-year outcomes. Addiction. 2005, 100 (s2): 59-69. 10.1111/j.1360-0443.2005.01028.x.CrossRefPubMed
5.
go back to reference Hughes JR, Keely J, Naud S: Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004, 99 (1): 29-38. 10.1111/j.1360-0443.2004.00540.x.CrossRefPubMed Hughes JR, Keely J, Naud S: Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004, 99 (1): 29-38. 10.1111/j.1360-0443.2004.00540.x.CrossRefPubMed
6.
go back to reference Lader D, Goddard E: Smoking related Behaviour and Attitudes, 2004. 2005, London: The Office for National StatisticsCrossRef Lader D, Goddard E: Smoking related Behaviour and Attitudes, 2004. 2005, London: The Office for National StatisticsCrossRef
7.
go back to reference Judge K, Bauld L, Chesterman J, Ferguson J: The English smoking treatment services: short-term outcomes. Addiction. 2005, 100 (s2): 46-58. 10.1111/j.1360-0443.2005.01027.x.CrossRefPubMed Judge K, Bauld L, Chesterman J, Ferguson J: The English smoking treatment services: short-term outcomes. Addiction. 2005, 100 (s2): 46-58. 10.1111/j.1360-0443.2005.01027.x.CrossRefPubMed
8.
go back to reference McEwen A, West R, McRobbie H: Effectiveness of specialist group treatment for smoking cessation vs. one-to-one treatment in primary care. Addictive Behaviors. 2006, 31 (9): 1650-1660. 10.1016/j.addbeh.2005.12.014.CrossRefPubMed McEwen A, West R, McRobbie H: Effectiveness of specialist group treatment for smoking cessation vs. one-to-one treatment in primary care. Addictive Behaviors. 2006, 31 (9): 1650-1660. 10.1016/j.addbeh.2005.12.014.CrossRefPubMed
9.
go back to reference NICE: Brief interventions and referral for smoking cessation in primary care and other settings. 2006, NICE Public Health Intervention Guidance no 1. London NICE: Brief interventions and referral for smoking cessation in primary care and other settings. 2006, NICE Public Health Intervention Guidance no 1. London
10.
go back to reference Coleman T, Wilson A: Anti-smoking advice from general practitioners: is a population-based approach to advice-giving feasible?. British Journal of General Practice. 2000, 50 (461): 1001-1004.PubMedPubMedCentral Coleman T, Wilson A: Anti-smoking advice from general practitioners: is a population-based approach to advice-giving feasible?. British Journal of General Practice. 2000, 50 (461): 1001-1004.PubMedPubMedCentral
11.
12.
go back to reference Coleman T, Wynn A, Barrett S, Wilson A: Discussion of NRT and other antismoking interventions in UK general practitioners' routine consultations. Nicotine & Tobacco Research. 2003, 5 (2): 163-168. 10.1080/1462220031000073261.CrossRef Coleman T, Wynn A, Barrett S, Wilson A: Discussion of NRT and other antismoking interventions in UK general practitioners' routine consultations. Nicotine & Tobacco Research. 2003, 5 (2): 163-168. 10.1080/1462220031000073261.CrossRef
13.
go back to reference Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005, 58 (2): 107-112. 10.1016/j.jclinepi.2004.09.002.CrossRefPubMed Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005, 58 (2): 107-112. 10.1016/j.jclinepi.2004.09.002.CrossRefPubMed
14.
go back to reference Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L: Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment. 2004 Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L: Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment. 2004
15.
go back to reference Michie S, Abraham C: Interventions to change health behaviours: evidence-based or evidence-inspired?. Psychol Health. 2004, 19 (1): 29-49. 10.1080/0887044031000141199.CrossRef Michie S, Abraham C: Interventions to change health behaviours: evidence-based or evidence-inspired?. Psychol Health. 2004, 19 (1): 29-49. 10.1080/0887044031000141199.CrossRef
16.
go back to reference Abraham C, Sheeran P, Johnston M: From health beliefs to self-regulation: Theoretical advances in the psychology of action control. Psychol Health. 1998, 13 (4): 569-591.CrossRef Abraham C, Sheeran P, Johnston M: From health beliefs to self-regulation: Theoretical advances in the psychology of action control. Psychol Health. 1998, 13 (4): 569-591.CrossRef
17.
go back to reference Orbell S: Motivational models, implementation intentions and the promotion of health behaviours. Social and Cognitive Perspectives on Medical Adherence. Edited by: Park DC, Liu LL. Washington: American Psychological Association. Orbell S: Motivational models, implementation intentions and the promotion of health behaviours. Social and Cognitive Perspectives on Medical Adherence. Edited by: Park DC, Liu LL. Washington: American Psychological Association.
18.
go back to reference Ajzen I: From intention to actions: A theory of planned behaviour. Action-control: From cognitive to behavior. Edited by: Kuhl J, Beckman J. 1985, Heidelberg: Springer, 11-39.CrossRef Ajzen I: From intention to actions: A theory of planned behaviour. Action-control: From cognitive to behavior. Edited by: Kuhl J, Beckman J. 1985, Heidelberg: Springer, 11-39.CrossRef
19.
go back to reference Bandura A: Social foundations of thought and action: a social cognitive theory. 1986, New Jersey: Prentice Hall Bandura A: Social foundations of thought and action: a social cognitive theory. 1986, New Jersey: Prentice Hall
20.
go back to reference Vogt F, Hall S, Marteau TM: General practitioners' and family physicians' negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review. Addiction. 2005, 100 (10): 1423-1431. 10.1111/j.1360-0443.2005.01221.x.CrossRefPubMed Vogt F, Hall S, Marteau TM: General practitioners' and family physicians' negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review. Addiction. 2005, 100 (10): 1423-1431. 10.1111/j.1360-0443.2005.01221.x.CrossRefPubMed
21.
go back to reference McEwen A, Akotia N, West R: General practitioners' views on the English national smoking cessation guidelines. Addiction. 2001, 96 (7): 997-1000. 10.1046/j.1360-0443.2001.9679978.x.CrossRefPubMed McEwen A, Akotia N, West R: General practitioners' views on the English national smoking cessation guidelines. Addiction. 2001, 96 (7): 997-1000. 10.1046/j.1360-0443.2001.9679978.x.CrossRefPubMed
22.
go back to reference Ritchie J, Lewis J: Qualitative Research Practice: A guide for Social Science Students and Researchers. 2003, London: Sage Ritchie J, Lewis J: Qualitative Research Practice: A guide for Social Science Students and Researchers. 2003, London: Sage
23.
go back to reference NICE: Guidance on the use of Nicotine replacement therapy (NRT) and bupropion for smoking cessation. Technology Appraisal. 2002, London: National Institute for Clinical Excellence NICE: Guidance on the use of Nicotine replacement therapy (NRT) and bupropion for smoking cessation. Technology Appraisal. 2002, London: National Institute for Clinical Excellence
24.
go back to reference Silverman D: Doing Qualitative Research: A practical handbook. 2000, London: Sage Silverman D: Doing Qualitative Research: A practical handbook. 2000, London: Sage
25.
go back to reference Vogt F, Hall S, Marteau TM: General practitioners' beliefs about effectiveness and intentions to recommend smoking cessation medications: qualitative and quantitative studies. BMC Public Health. 2006, 6 (277): Vogt F, Hall S, Marteau TM: General practitioners' beliefs about effectiveness and intentions to recommend smoking cessation medications: qualitative and quantitative studies. BMC Public Health. 2006, 6 (277):
26.
go back to reference Potts HW, Wyatt JC: Survey of doctors' experience of patients using the Internet. Journal of Medical Internet Research. 2002, 4 (1): e5-10.2196/jmir.4.1.e5.CrossRefPubMedPubMedCentral Potts HW, Wyatt JC: Survey of doctors' experience of patients using the Internet. Journal of Medical Internet Research. 2002, 4 (1): e5-10.2196/jmir.4.1.e5.CrossRefPubMedPubMedCentral
27.
go back to reference Godin G, Kok G: The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion. 1996, 11 (2): 87-98.CrossRefPubMed Godin G, Kok G: The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion. 1996, 11 (2): 87-98.CrossRefPubMed
28.
go back to reference Klem L: Path Analysis. Reading and understanding multivariate statistics. Edited by: Grimm LG, Yarnold PR. 2001, Washington: American Psychological Association, 65-96. Klem L: Path Analysis. Reading and understanding multivariate statistics. Edited by: Grimm LG, Yarnold PR. 2001, Washington: American Psychological Association, 65-96.
29.
go back to reference Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986, 51: 1173-1182. 10.1037/0022-3514.51.6.1173.CrossRefPubMed Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986, 51: 1173-1182. 10.1037/0022-3514.51.6.1173.CrossRefPubMed
30.
go back to reference Preacher KJ, Hayes AF: SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments & Computing. 2004, 36 (4): 717-731.CrossRef Preacher KJ, Hayes AF: SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments & Computing. 2004, 36 (4): 717-731.CrossRef
31.
go back to reference Arbuckle JL: Amos. 1994, Chicago: SmallWaters, 4.01 Arbuckle JL: Amos. 1994, Chicago: SmallWaters, 4.01
32.
go back to reference Hesterberg T, Moore DS, Monaghan S, Clipson A, Epstein R: Chapter 14: Bootstrap Methods and Permutation Tests. Introduction to the Practice of Statistics. Edited by: Moore DS, McCabe GP. 2005, New York: W H Freeman & Co Hesterberg T, Moore DS, Monaghan S, Clipson A, Epstein R: Chapter 14: Bootstrap Methods and Permutation Tests. Introduction to the Practice of Statistics. Edited by: Moore DS, McCabe GP. 2005, New York: W H Freeman & Co
33.
go back to reference Bollen KA: Structural Equations with Latent Variables. 1989, New York: John Wiley and SonsCrossRef Bollen KA: Structural Equations with Latent Variables. 1989, New York: John Wiley and SonsCrossRef
34.
go back to reference Cohen J: Statistical power analysis for the behavioral sciences. 1988, Hillsdale, NJ: Lawrence Earlbaum Associates, 2 Cohen J: Statistical power analysis for the behavioral sciences. 1988, Hillsdale, NJ: Lawrence Earlbaum Associates, 2
35.
go back to reference Lancaster T, Dobbie W, Vos K, Yudkin P, Murphy M, Fowler G: Randomized trial of nurse-assisted strategies for smoking cessation in primary care. The British Journal Of General Practice. 1999, 49 (440): 191-PubMedPubMedCentral Lancaster T, Dobbie W, Vos K, Yudkin P, Murphy M, Fowler G: Randomized trial of nurse-assisted strategies for smoking cessation in primary care. The British Journal Of General Practice. 1999, 49 (440): 191-PubMedPubMedCentral
36.
go back to reference Stead LF, Lancaster T: Group behaviour therapy programmes for smoking cessation. The Cochrane Database of Systematic Reviews. 2003, 1 Stead LF, Lancaster T: Group behaviour therapy programmes for smoking cessation. The Cochrane Database of Systematic Reviews. 2003, 1
37.
go back to reference Cook RJ, Sackett DL: The number needed to treat: a clinically useful measure of treatment effect. Br Med J. 1995, 310 (6977): 452-454.CrossRef Cook RJ, Sackett DL: The number needed to treat: a clinically useful measure of treatment effect. Br Med J. 1995, 310 (6977): 452-454.CrossRef
38.
go back to reference Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE: The Effects of a Smoking Cessation Intervention on 14.5-Year Mortality: A Randomized Clinical Trial. Ann Intern Med. 2005, 142 (4): 233-239.CrossRefPubMed Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE: The Effects of a Smoking Cessation Intervention on 14.5-Year Mortality: A Randomized Clinical Trial. Ann Intern Med. 2005, 142 (4): 233-239.CrossRefPubMed
39.
go back to reference Hebert P, Gaziano J, Chan K, Hennekens C: Cholesterol lowering with statin drugs, risk of stroke, and total mortality. Journal of the American Medical Association JAMA. 1997, 278: 313-321. 10.1001/jama.278.4.313.CrossRefPubMed Hebert P, Gaziano J, Chan K, Hennekens C: Cholesterol lowering with statin drugs, risk of stroke, and total mortality. Journal of the American Medical Association JAMA. 1997, 278: 313-321. 10.1001/jama.278.4.313.CrossRefPubMed
40.
go back to reference McEwen A, West R, Owen L: GP prescribing of nicotine replacement and bupropion to aid smoking cessation in England and Wales. Addiction. 2004, 99 (11): 1470-1474. 10.1111/j.1360-0443.2004.00876.x.CrossRefPubMed McEwen A, West R, Owen L: GP prescribing of nicotine replacement and bupropion to aid smoking cessation in England and Wales. Addiction. 2004, 99 (11): 1470-1474. 10.1111/j.1360-0443.2004.00876.x.CrossRefPubMed
41.
go back to reference Kahneman D, Tversky A: Prospect theory: an analysis of decision under risk. Econometrica. 1979, 47 (2): 236-291. 10.2307/1914185.CrossRef Kahneman D, Tversky A: Prospect theory: an analysis of decision under risk. Econometrica. 1979, 47 (2): 236-291. 10.2307/1914185.CrossRef
42.
go back to reference Yzer MC, Cappella JN, Fishbein M, Hornik R, Ahern RK: The effectiveness of gateway communications in anti-marijuana campaigns. Journal Of Health Communication. 2003, 8 (2): 129-143. 10.1080/10810730305695.CrossRefPubMedPubMedCentral Yzer MC, Cappella JN, Fishbein M, Hornik R, Ahern RK: The effectiveness of gateway communications in anti-marijuana campaigns. Journal Of Health Communication. 2003, 8 (2): 129-143. 10.1080/10810730305695.CrossRefPubMedPubMedCentral
43.
go back to reference Sutton S: Predicting and explaining intentions and behavior: how well are we doing?. J Appl Soc Psychol. 1998, 28 (15): 1317-1338. 10.1111/j.1559-1816.1998.tb01679.x.CrossRef Sutton S: Predicting and explaining intentions and behavior: how well are we doing?. J Appl Soc Psychol. 1998, 28 (15): 1317-1338. 10.1111/j.1559-1816.1998.tb01679.x.CrossRef
Metadata
Title
General practitioners' beliefs about effectiveness and intentions to recommend smoking cessation services: qualitative and quantitative studies
Authors
Florian Vogt
Sue Hall
Theresa M Marteau
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2007
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-8-39

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