Does the smoking status of general practitioners affect the efficacy of smoking cessation counselling?

Abstract

Objective To examine the association between the smoking status of general practitioners (GPs) and abstinence rates among patients receiving GP-delivered brief advice for smoking cessation. Methods A quasi-experimental multilevel study with follow-up assessments at 6, 12, 18, and 24 months after baseline was conducted using a random sample of 39 general practices in a defined area (participation rate = 87.2%). Patients aged 18–70 were consecutively screened for smoking status ( n = 11,560) over the course of 3 weeks and were assigned to a control group (week 1), a computer expert system intervention (week 2), or a personal counselling intervention with the GP (week 3). For the current analysis, patients participating in study week 2 were excluded. A total of 1260 patients fulfilled the inclusion criteria and 80.2% took part: 609 patients in study week 1 and 402 patients from study week 3. GPs participated in a training session concerning smoking counselling, which was held between study weeks 2 and 3. Self-reported 4-week and 6-month prolonged abstinence measures at the 6-, 12-, 18-, and 24-month follow-ups were assessed. Results The smoking status of the GP was neither significantly related to 4-week prolonged abstinence nor 6-month prolonged abstinence among patients in a main effects model. Further modelling revealed that the intervention group modified the effect of the non-smoking status of the GP on the likelihood to quit smoking. A significant interactive effect was found between the non-smoking status of the GP and the intervention group on both abstinence measures. Conclusion The non-smoking status of the GP had a positive effect among counselled patients. Practice implications The consideration of lifestyle behavioural variables such as the smoking status of the GP will be essential for further research concerning the efficacy of smoking interventions.