SMOKING CESSATION COUNSELING BY RESIDENTS IN AN OUTPATIENT-CLINIC

Background. Training residents in smoking cessation counseling could b et part of tobacco control policy. The effect of such an intervention is unknown in Europe. This study provides an assessment of smoking ces sation counseling practices by Swiss residents after an intervention b ased on behavioral modification.Method. In a pre-post blind test trial on smoking cessation counseling practices, residents' perceptions abo ut their own ability to counsel smoking behavior among smoking patient s were evaluated for 15 residents trained in general internal medicine and in 247 and 155 smoking patients' reports, respectively before and after a training intervention targeting. residents, based on behavior al theory of smoking cessation. Results. Changes in counseling were as sessed by interviews with patients. After the intervention, residents asked about smoking habits (77 vs 68%), advised to quit (43 vs 28%), p rovided counseling for cessation (25 vs 10%), gave self-help materials (7 vs 14%), and arranged follow-up visits (5 vs 1%) more often than b efore. Residents' self-perception of confidence (5.4 vs 4.6/10) and ef fectiveness (5.3 vs 4.0/10) in counseling also increased after the int ervention. After adjusting for daily cigarette consumption and smoking duration, the likelihood of attempting to quit smoking at either 6 or 12 months was increased in the group of patients attended after the i ntervention (odds ratio 1.52, 95% confidence intervals 1.07-2.48). How ever, the likelihood of quitting smoking was not increased among these patients (odds ratio 1.07, 95% CI 0.96-1.14). Conclusions. Short-term smoking cessation counseling by residents was substantially improved by the intervention. Smokers attended after the intervention were more likely to attempt to quit smoking, but not to have quit at 6- or 12-m onth follow-up. (C) 1997 Academic Press.