Specialist medical prescription or medical counseling in primary care: opinions from the other side of the table

OBJECTIVES: To estimate the frequency, characteristics and follow-up of ant i-smoking counseling given to patients using a primary care facility; to su rvey patient opinion of anti-smoking advice offered. MATERIAL AND METHODS: Cross-sectional, descriptive study at a primary care facility. Subjects: random sample of 330 patients between 15 and 75 years o f age using the primary care facility in March and April 2000. Measurements : confidential survey by self-administered questionnaire on smoking, chroni c disease related to smoking, anti-smoking advice given and patient opinion of anti-smoking counseling by health care givers. RESULTS: The prevalence of smoking was 31.9% (100). Among patients who were either smokers or ex-smokers (162), advice to stop smoking had been receiv ed from the primary care physician by 47 patients (29.2%), from a specialis t by 19 (11.8%), from a nurse by 14 (8.7%), from a pharmacist by 5 (3.1%), and from family by 34 (21.1%). We found no statistically significant differ ences related to gender or age for advice to stop smoking, although the pre sence or absence of chronic disease did affect counseling. Fifty-four (65%) of those who had been advised to quit considered that the time spent couns eling was adequate. Ten patients (12%) received an informative brochure in addition to counseling. Forty smokers (40%) stated that they would quit smo king if their doctor advised them to and 45 (45%) would do so if they had a smoking-related disease. Thirty-three smokers (33%) believed that they sho uld receive advice about smoking at all visits to the doctor, whereas 38 (3 8%) believed such counseling was appropriate only if the visit was for a sm oking-related disease. CONCLUSIONS: The prevalence of smoking among patients who use primary care facilities is high. The frequency of advice to quit smoking is low, and rem inders and follow-up are minimal. After learning a patient's habits and stu dying them, professional anti-smoking advice should always be given, with a ppropriate monitoring and follow-up.