Family physicians’ barriers to addressing patients smoking: cross-sectional data from 2002 and 2014

Abstract

Abstract Background Family physicians have an excellent opportunity at primary health care level to influence patients' smoking behavior. Routine screening of all patients for tobacco use is recommended. The objective of the present study was to explore factors related to addressing patients' smoking habits among FPs. Methods Two postal cross-sectional surveys were conducted among the sample of all practicing physicians in Estonia (n = 4140 in 2002, n = 5666 in 2014). Questionnaires of under 65-year-old FPs were included (n = 473 in 2002, n = 468 in 2014). Frequency of addressing patients' smoking habits and agreement with statements concerning perceived barriers, along with confidence intervals (CI) were calculated. Associations of addressing patients' smoking habits at least once during last 7 days with perceived barriers were calculated using logistic regression analysis. Fully adjusted odds ratios (OR) were determined with corresponding 95% (CI). Results The prevalence of addressing patients' smoking at least once during last 7 days was 96.4% (95% CI 94.2-98.7) in 2002 and 97.1% (95% CI 95.0-99.1) in 2014. FPs who agreed that lack of time is a barrier to addressing patients' smoking, were significantly more likely to address patients' smoking (OR 3.53; 95% CI 1.36-9.16) compared to FPs who did not agree with the statement. FPs who agreed that lack of habit is a barrier, were significantly less likely to address patients' smoking (OR 0.14; 95% CI 0.06-0.34) compared to FPs who did not agree. FPs smoking status was not significantly associated with addressing patients' smoking. Conclusions Majority of family physicians addressed patients' smoking habits. Addressing patients' smoking habits was significantly associated with agreeing that lack of time and lack of habit is a barrier to addressing patients' smoking. Results of the present study are useful for policymakers and other institutions involved in organization and development of smoking prevention training and cessation services. Key messages Majority of family physicians addressed patients’ smoking. Addressing patients’ smoking was significantly associated with lack of time and lack of habit as barriers to addressing patients’ smoking. Smoking prevention training and organization of cessation services would further enable family physicians to routinely address patients’ smoking habits.