Providers' smoking cessation attitudes and practices for older patients

A mail survey of 136 providers in a health maintenance organization in the Chicago metropolitan area examined smoking cessation attitudes and performa nce of the 4As protocol (asking, advising, assisting, arranging) for patien ts aged 50 years or older Asking about smoking was most frequent, followed by arranging, advising, and assisting. Physicians and nurse practitioners p erformed each of the 4As more often than did registered and licensed practi cal nurses. In multiple logistic regression analyses, provider type was the only significant predictor of asking about smoking. Advising, assisting, a nd arranging follow-ups were more likely to be performed by providers who p erceived a sense of professional responsibility about older patients' smoki ng; advising was more likely for providers who perceived that they had enou gh time to advise older patients about smoking; and assisting and arranging were more likely for providers with a stronger sense of self-efficacy for helping older patients stop smoking.