Physicians' involvement in the smoking cessation process of their patients- Results of a 1998 survey among 4 643 Belgian physicians

This report relates to the 1 667 responses to a selfadministered mail-back questionnaire sent by BELTA to a sample of 4 643 physicians (17.3% current smokers) who are in professional contact with patients (response rate: 35.9 %). Links between active smoking and disease are considered as well-demonstrate d by 98.8% physicians and for passive smoking by 85.3%, for foetal conseque nces of smoking during pregnancy by 96.4%. Nicotine dependence is admitted by 83.3%. Interaction of smoking with drug metabolism is insufficiently kno wn. Modulation of the specific approach of smoking cessation, according to the various stages of the cessation cycle, to the level of nicotine dependence and to the psychological status of the smoker is not sufficiently perceived by the physicians. Patient's smoking status is systematically determined b y less than half the physicians, of whom nearly 90% claim to inform their s moking patients on smoking-related risks, and 84.2% to tackle the problem o f cessation. The intervention is mostly limited to a firm advice, completed by nicotine replacement for a maximum of 50% of smokers (especially gum an d patch). Referral to specialized structures is unfrequent(between 10 and 2 0%). Follow up after cessation is deafly deficient. In this retrospective study of their activity patterns, physicians' reports may reflect their intentions rather than their actual practices. We conclude that smoking issues and cessation techniques should be moro int ensively taught both at graduate and postgraduate levels, in order to obtai n a more active behaviour of health professionals against smoking.