ATTITUDES AND PRACTICES FOR SMOKING CESSATION COUNSELING BY PROVIDER TYPE AND PATIENT AGE

Attitudes and self-reported practices for smoking cessation counseling among 145 providers at a health maintenance organization were compare d among two provider groups, physicians/nurse practitioners and regist ered/licensed practical nurses, and across three patient age groups, < 50, 50-64, and greater-than-or-equal-to 65. Smoking cessation attitude s did not differ by provider type but they did differ by patient age, especially among the registered/licensed practical nurses, whose attit udes were least favorable for the oldest smokers (greater-than-or-equa l-to 65). While smoking cessation practices did not differ by patient age, they did differ by provider type. Self-reported performance of th e 4 As of smoking cessation practice (Ask, Advise, Assist, Arrange) wa s more frequent among the physicians/nurse practitioners than among th e registered/licensed practical nurses. However, among both groups, as king and advising practices were reported more often than were assisti ng and arranging. In all cases, different attitudes were correlated wi th different practice behaviors for the two provider groups. Also, the re were more significant correlations between age-specific attitudes a nd practices among the registered/licensed practical nurses than among the physicians/nurse practitioners. This was true especially regardin g the oldest patients. The findings suggest a need for provider educat ion, especially among registered/licensed practical nurses, about the benefits of smoking cessation for patients of all ages and the potenti al effectiveness of provider-based intervention strategies that are ta rgeted toward specific age groups. The findings also suggest that assi sting and arranging practices in particular need improvement among all types of providers. (C) 1995 Academic Press, Inc.