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Smoking Cessation Counseling by Resident Physicians in Internal Medicine, Family Practice, and Pediatrics
Richard D. Kenney, MD;
Mary F. Lyles, MD;
Robert C. Turner, MD;
Susanne T. White, MD;
Jorge J. Gonzalez, MD;
Thomas G. Irons, MD;
Clare J. Sanchez, MD;
C. Stewart Rogers, MD;
Elizabeth E. Campbell, MD;
Victor G. Villagra, MD;
Victor J. Strecher, PhD;
Michael S. O'Malley, MSPH;
Frank T. Stritter, PhD;
Suzanne W. Fletcher, MD, MSc
Arch Intern Med. 1988;148(11):2469-2473.
Abstract
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• Residents in primary care specialties care for many patients who smoke cigarettes, but little is known about their smoking cessation counseling (SCC). We surveyed 309 residents (72 family practice, 171 internal medicine, and 66 pediatrics residents) in 13 programs to determine their practices, knowledge, attitudes, and training in SCC. More than 90% thought physicians are responsible for SCC, the majority routinely took smoking histories, and 80% attempted to motivate patients to quit smoking. However, 25% or fewer reported discussing obstacles to quitting, setting a quit date, prescribing nicotine gum, scheduling follow-up visits, or providing self-help materials. Family practice residents used more SCC techniques (1.8) than did internal medicine (0.8) and pediatrics (0.1) residents. Only 54% of residents reported recent SCC training and 13% reported formal SCC training. Recent training correlated with the number of counseling techniques used. Residents in primary care specialties report positive attitudes but inadequate practice and training in SCC.
(Arch Intern Med 1988;148:2469-2473)
Author Affiliations
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From the University of North Carolina Faculty Development Program in General Medicine and General Pediatrics, the Departments of Pediatrics (Drs Kenney and White) and Medicine (Drs Gonzalez, Sanchez, Rogers, Campbell, and Fletcher and Mr O'Malley), the Office of Research and Development in Education for the Health Professions (Dr Stritter), and the Area Health Education Centers Program (Drs Kenney, White, Gonzalez, Sanchez, Rogers, and Campbell), School of Medicine; the Departments of Health Education (Strecher), Health Policy and Administration (Mr O'Malley), and Epidemiology (Dr Fletcher), School of Public Health; and the Lineberger Cancer Research Center (Dr Fletcher), University of North Carolina at Chapel Hill; the Department of Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC (Dr Lyles); the Departments of Medicine (Dr Turner) and Pediatrics (Dr Irons), East Carolina University School of Medicine, Greenville, NC; and the Geisinger Medical Center, Danville, Pa (Dr Villagra).
Footnotes
Accepted for publication June 7, 1988.
Reprint requests to Division of General Internal Medicine, Department of Medicine, University of North Carolina at Chapel Hill, School of Medicine, Box 2 Room 5039, Old Clinic Bldg CB 7110, Chapel Hill, NC 27599-7110 (Dr Fletcher).
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