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

Patient Educ Couns. 2009 Jan;74(1):23-8. doi: 10.1016/j.pec.2008.07.047. Epub 2008 Sep 24.

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.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Computer-Assisted Instruction / methods*
  • Counseling / methods
  • Family Practice / methods*
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care
  • Patient Education as Topic / methods
  • Physicians, Family / education
  • Physicians, Family / organization & administration
  • Physicians, Family / psychology*
  • Practice Patterns, Physicians' / organization & administration
  • Smoking / epidemiology
  • Smoking / psychology*
  • Smoking Cessation* / psychology
  • Smoking Cessation* / statistics & numerical data
  • Smoking Prevention
  • Surveys and Questionnaires