MAKING TIME FOR TOBACCO CESSATION COUNSELING

BACKGROUND. The objective of this study was to examine the incidence, targeting, and time demands of tobacco cessation advice by community f amily physicians. METHODS. Research nurses directly observed 2 days of outpatient visits to 138 family physicians in northeast Ohio. Smoking status was identified by patient questionnaire. Visit characteristics were determined from direct observation and billing data. Visits by s mokers with and without smoking cessation advice were compared. RESULT S. The incidence of tobacco cessation advice was highest during wellne ss visits (55% vs 22% for illness visits; P<.001). Smokers seen for a tobacco-related chronic illness were more likely to receive advice tha n those seen for a chronic problem not related to tobacco (32% vs 17%; P=.05). The average duration of advice was less than 1 1/2 minutes. T here were no significant differences in the duration of advice across different types of visits. CONCLUSIONS. Physicians are providing brief , targeted interventions for smoking cessation in family practices. Th e findings support the feasibility of implementing a brief interventio n with all smokers seen during office visits.