QUALITATIVE STUDY OF PATIENTS PERCEPTIONS OF DOCTORS ADVICE TO QUIT SMOKING - IMPLICATIONS FOR OPPORTUNISTIC HEALTH PROMOTION

Objectives: To determine the effectiveness and acceptability of genera l practitioners' opportunistic antismoking interventions by examining detailed accounts of smokers' experiences of these. Design: Qualitativ e semistructured interview study. Setting: South Wales. Subjects: 42 p articipants in the Welsh smoking intervention study were asked about i nitial smoking, attempts to quit, thoughts about future smoking, past experiences with the health services, and the most appropriate way for health services to help them and other smokers. Results: Main emergin g themes were that subjects already made their own evaluations about s moking, did not believe doctors' words could influence their smoking, believed that quitting was down to the individual, and felt that docto rs who took the opportunity to talk about smoking should focus on the individual patient Smokers anticipated that they would be given antism oking advice by doctors when attending: for health care; they reacted by shrugging this off, feeling guilty, or becoming annoyed. These reac tions affected the help seeking behaviour of some respondents, Smokers were categorised as ''contrary;'' ''matter of fact'' and ''self blami ng'' depending on their reported reaction to antismoking advice. Concl usions: Doctor-patient relationships can be damaged if doctors routine ly advise all smokers to quit. Where doctors intervene, a patient cent red approach-one that considers how individual patients view themselve s as smokers and how they are likely to react to different styles of i ntervention-is the most acceptable.