Response to a smoking cessation workshop by family practice resident physicians

Abstract

Department of Family Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA C A Jones Abstract Objective -To determine the effective ness of a smoking cessation workshop to train resident physicians to apply smok ing cessation techniques to their patients. Design Retrospective review of pat ients' notes after physicians had partici pated in a three-hour workshop on smok ing cessation and patients' notes had been flagged to prompt physicians to ask about smoking status. Setting Family practice clinic of a university-based family medicine resi dency programme. Subjects Nineteen resident physicians and 149 patient records. Main outcome measures?Physicians' response to patients who smoke in (a) giving advice to stop smoking, (6) estab lishing a date to stop smoking, and (c) making referrals for psychological coun selling. Results Comparison of 46 patient re cords before the workshop and 57 ident ified two months after the workshop showed that resident physicians' sensi tivity to patients' smoking status, espec ially in offering advice about smoking, increased initially after the workshop (p < 0.001). Establishing a date to stop smoking and making psychological re ferrals also increased, though not signifi cantly (stopping date, p < 0.085; referral, p < 0.149). However, none of the three behaviours was sustained over time. A comparison of the pre-workshop records with 46 records identified six months after the workshop showed that none of the outcome measures showed significant differences, and psychological referrals actually decreased. Conclusions A single three-hour train ing workshop on counselling techniques for stopping smoking and the flagging of patients' notes to prompt physicians to ask about smoking are not sufficient to produce a sustained effect over a six month period. Successful integration of appropriate physician behaviours into a practice requires systems that reinforce the involvement of physicians and use techniques that help physicians internal ise health promotion with their smoking patients. (Tobacco Control 1993; 2: 30-34) Introduction