Do Doctors Stop Giving Quit-Smoking Advice When Other Programs are Reaching Their Patients?

Abstract

The authors attempted to determine if the self-reported practices of hospital doctors regarding smoking cessation advice to their patients, would be influenced by the introduction of a scheme in which smokers were routinely identified on admission to hospital and were subsequently mailed letters including cessation advice. The second objective was to assess the relative levels of cessation counselling among different categories of doctors. Five hundred and fifteen doctors from two large public teaching hospitals in Melbourne, Australia participated in the study. Mail-out cessation advice took place in one hospital (the intervention hospital). In both hospitals, half of the doctors were surveyed 6 weeks before the mailing had commenced, and the remaining half were surveyed 6 months after. There were no significant differences between doctors at the intervention hospital and doctors at the control hospital in the self-reported advice to patients. Most doctors "encouraged patients to quit whenever possible." However, this encouragement seemed to be limited to talking to patients about the risks of smoking. Doctors less frequently gave advice concerning how to stop smoking. Compared with other doctors, internists seemed to be the most willing to encourage patients to quit and they reported higher levels of assisting patients to quit. There was no evidence that reminding doctors regularly that their patients were receiving mailed cessation advice significantly increased or decreased doctor's reporting smoking cessation activities with their patients. Internists are more involved in smoking cessation counselling than other types of doctors.