PATIENTS PERCEPTIONS OF THEIR PHYSICIANS ROLE IN SMOKING CESSATION BYAGE AND READINESS TO STOP SMOKING

Background Patients' perceptions of their physician's role in smoking cessation, using the 4As protocol (asking, advising, assisting, and ar ranging), were assessed with a focus on associations with age (18-29, 30-49, and greater than or equal to 50) and stage of readiness to stop smoking (precontemplation, contemplation, and preparation). Methods. Self-administered questionnaires were completed by 524 smokers present ing for regularly scheduled appointments at six clinics of an HMO in t he Chicago metropolitan area. Results. Almost all patients said their physician should ask about their smoking status and advise them to qui t. About half said their physician should assist them with quitting, a nd about two-thirds said their physician should follow up (arrange) on their smoking behavior. Bivariate associations were found for endorse ment of the 4As with both age and stage. Multiple logistic regressions found age was the most consistent and strongest correlate of 4As endo rsement, with younger smokers more likely than those age 50 or older t o endorse the 4As protocol. Conclusions. A proactive health promotion orientation should be encouraged among physicians. Patients should be screened for stage of readiness to stop smoking so that health care pr oviders can emphasize aspects of the 4As protocol that are most approp riate for each patient. Age-tailored smoking cessation strategies shou ld be employed within stages of readiness to stop smoking. (C) 1997 Ac ademic Press.