A survey of physicians' smoking counseling practices

Several techniques used in smoking cessation counseling have been shown to be useful in physicians' efforts to help their patients quit smoking. The use of these techniques by Tulsa physicians was assessed through a survey of private practice internists, internal medicine residents, and family practice residents in a university-based community hospital. The majority of physicians (85%) reported they brought up the subject of smoking with their patients. Other techniques were used less frequently, with 34% of physicians never giving their patients self-help materials, 83% never using a quit date contract, and 73% never making appointments mainly to discuss smoking. Private practice physicians reported using more techniques than did the residents. Internists who practice a subspecialty reported using fewer techniques, and this was especially true in the younger physicians. Ten percent of physicians were often satisfied with their efforts, and 14% had formal training in smoking counseling techniques. Some physicians apparently learn how to better use these techniques as their experience increases. Training physicians while they are in residency and early subspecialty practice may accelerate this process and enable more smokers to quit with their physicians' help.