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Activating patients for smoking cessation through physician autonomy support.

G C Williams1, E L Deci

  • 1Department of Medicine, University of Rochester, New York, USA. Geoffrey_Williams@urmc.rochester.edu

Medical Care
|July 27, 2001
PubMed
Summary

Physicians using an autonomy-supportive style increased patient involvement in smoking cessation counseling. This enhanced involvement, in turn, led to higher rates of sustained abstinence from smoking over 30 months.

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Area of Science:

  • Behavioral Medicine
  • Public Health
  • Clinical Psychology

Background:

  • Smoking cessation counseling is crucial for public health.
  • Physician communication style can influence patient engagement.
  • Autonomy-supportive approaches may enhance patient motivation.

Purpose of the Study:

  • To evaluate the impact of autonomy-supportive versus controlling physician counseling styles on patient involvement and smoking cessation.
  • To determine if increased patient involvement mediates the effect of counseling style on sustained abstinence.

Main Methods:

  • A randomized trial involving 27 physicians and 249 adult smokers.
  • Physicians used either an autonomy-supportive or controlling style for smoking cessation counseling.
  • Patient involvement was rated from audio recordings; smoking cessation was assessed via self-report and CO validation over 30 months.

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Main Results:

  • Physician style did not directly impact smoking cessation but significantly increased patient active involvement.
  • Patient active involvement was positively associated with increased continuous smoking abstinence.
  • Structural equation modeling supported a model where autonomy-supportive style led to involvement, which led to abstinence.

Conclusions:

  • An autonomy-supportive physician counseling style enhances patient involvement in smoking cessation.
  • Increased patient involvement is a key factor in achieving sustained smoking abstinence.
  • Further research is needed to explore direct physician style effects on health outcomes.