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Direct observation of smoking cessation activities in primary care practice.
J Fam Pract. 2001 Aug; 50(8):688-93.JF

Abstract

OBJECTIVE

Our goals were to determine how often family physicians incorporate smoking cessation efforts into routine office visits and to examine the effect of patient, physician, and office characteristics on the frequency of these efforts.

STUDY DESIGN

Data was gathered using direct observation of physician-patient encounters, a survey of physicians, and an on-site examination of office systems for supporting smoking cessation.

POPULATION

We included patients seen for routine office visits in 38 primary care physician practices.

OUTCOMES MEASURED

The frequency of tobacco discussions among all patients, the extent of these discussions among smokers, and the presence of tobacco-related systems and policies in physicians' offices were measured.

RESULTS

Tobacco was discussed during 633 of 2963 encounters (21%; range among practices = 0%-90%). Discussion of tobacco was more common in the 58% of practices that had standard forms for recording smoking status (26% vs 16%; P=.01). Tobacco discussions were more common during new patient visits but occurred less often with older patients and among physicians in practice more than 10 years. Of 244 smokers identified, physicians provided assistance with smoking cessation for 38% (range among practices = 0%-100%). Bupropion and nicotine-replacement therapy were discussed with smokers in 31% and 17% of encounters, respectively. Although 68% of offices had smoking cessation materials for patients, few recorded tobacco use in the "vital signs" section of the patient history or assigned smoking-related tasks to nonphysician personnel.

CONCLUSIONS

Smoking cessation practices vary widely in primary care offices. Strategies are needed to assist physicians with incorporating systematic approaches to maximize smoking cessation rates.

Authors+Show Affiliations

Department of Preventive Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160-7313, USA. eellerbe@kumc.edu.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11509163

Citation

Ellerbeck, E F., et al. "Direct Observation of Smoking Cessation Activities in Primary Care Practice." The Journal of Family Practice, vol. 50, no. 8, 2001, pp. 688-93.
Ellerbeck EF, Ahluwalia JS, Jolicoeur DG, et al. Direct observation of smoking cessation activities in primary care practice. J Fam Pract. 2001;50(8):688-93.
Ellerbeck, E. F., Ahluwalia, J. S., Jolicoeur, D. G., Gladden, J., & Mosier, M. C. (2001). Direct observation of smoking cessation activities in primary care practice. The Journal of Family Practice, 50(8), 688-93.
Ellerbeck EF, et al. Direct Observation of Smoking Cessation Activities in Primary Care Practice. J Fam Pract. 2001;50(8):688-93. PubMed PMID: 11509163.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Direct observation of smoking cessation activities in primary care practice. AU - Ellerbeck,E F, AU - Ahluwalia,J S, AU - Jolicoeur,D G, AU - Gladden,J, AU - Mosier,M C, PY - 2001/8/18/pubmed PY - 2001/9/8/medline PY - 2001/8/18/entrez SP - 688 EP - 93 JF - The Journal of family practice JO - J Fam Pract VL - 50 IS - 8 N2 - OBJECTIVE: Our goals were to determine how often family physicians incorporate smoking cessation efforts into routine office visits and to examine the effect of patient, physician, and office characteristics on the frequency of these efforts. STUDY DESIGN: Data was gathered using direct observation of physician-patient encounters, a survey of physicians, and an on-site examination of office systems for supporting smoking cessation. POPULATION: We included patients seen for routine office visits in 38 primary care physician practices. OUTCOMES MEASURED: The frequency of tobacco discussions among all patients, the extent of these discussions among smokers, and the presence of tobacco-related systems and policies in physicians' offices were measured. RESULTS: Tobacco was discussed during 633 of 2963 encounters (21%; range among practices = 0%-90%). Discussion of tobacco was more common in the 58% of practices that had standard forms for recording smoking status (26% vs 16%; P=.01). Tobacco discussions were more common during new patient visits but occurred less often with older patients and among physicians in practice more than 10 years. Of 244 smokers identified, physicians provided assistance with smoking cessation for 38% (range among practices = 0%-100%). Bupropion and nicotine-replacement therapy were discussed with smokers in 31% and 17% of encounters, respectively. Although 68% of offices had smoking cessation materials for patients, few recorded tobacco use in the "vital signs" section of the patient history or assigned smoking-related tasks to nonphysician personnel. CONCLUSIONS: Smoking cessation practices vary widely in primary care offices. Strategies are needed to assist physicians with incorporating systematic approaches to maximize smoking cessation rates. SN - 0094-3509 UR - https://www.unboundmedicine.com/medline/citation/11509163/Direct_observation_of_smoking_cessation_activities_in_primary_care_practice_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11509163.ui DB - PRIME DP - Unbound Medicine ER -