PHYSICIANS COUNSELING SMOKERS - A POPULATION-BASED SURVEY OF PATIENTSPERCEPTIONS OF HEALTH-CARE PROVIDER-DELIVERED SMOKING CESSATION INTERVENTIONS

Objective: To examine associations between sociodemographic and psycho logical characteristics of smokers and delivery of 5 types of smoking cessation counseling interventions by physicians and office staff. Met hods: We used a telephone survey of a population-based sample of adult cigarette smokers (N=3037) who saw a physician in the last year. Prim ary outcomes included patients' report of whether a physician or other health care provider (1) talked about smoking, (2) advised them to qu it, (3) offered help to quit, (4) arranged a follow-up contact, and (5 ) prescribed nicotine gum or other medication. Results: Fifty-one perc ent of smokers were talked to about their smoking; 45.5% were advised to quit; 14.9% were offered help; 3%, had a follow-up appointment arra nged; and 8.5% were prescribed medication. In multivariate analyses, t he most consistent predictors of receipt of almost all counseling beha viors were medical setting (private physician's office only > care in other settings), health status (fair or poor > good, very good, or exc ellent), more years of education, greater number of cigarettes smoked per day, stage of readiness to quit smoking (preparation > precontempl ation), and greater reported benefits of smoking. Conclusions: Physici ans and other health care providers are not meeting the standards of s moking intervention outlined by the National Cancer Institute and the Agency for Health Care Policy and Research. Health care providers who intervene only with those patients who are ready to quit smoking are m issing opportunities to provide effective smoking interventions to the majority of their patients. Interventions are also less likely to be provided to healthier and lighter smokers.