Training physicians to do office-based smoking cessation increases adherence to PHS guidelines.

Area of Science:

• Public Health
• Medical Education
• Behavioral Science

Background:

• Cigarette smoking is a leading cause of preventable death and disease in the U.S.
• Physician advice is a critical factor in smoking cessation, yet most smokers do not receive it.
• The Morehouse School of Medicine developed best practices for tobacco cessation among African American physicians.

Purpose of the Study:

• To develop and test an intervention to improve physician compliance with the Public Health Services (PHS) Clinical Practice Guidelines on Treating Tobacco Use and Dependence.
• To address barriers faced by physicians in providing smoking cessation services.

Main Methods:

• Conducted ten focus groups with 82 healthcare professionals to identify barriers.
• Developed and implemented an intervention based on focus group findings.
• Abstracted 308 patient charts pre- and post-intervention to assess the use of the PHS "5 A's" (Ask, Advise, Assess, Assist, Arrange).

Main Results:

• Identified six major themes as barriers to providing smoking cessation services.
• The mean "5 A's" score increased significantly from 1.29 pre-intervention to 1.90 post-intervention (P < 0.001).
• Statistically significant increases were observed for all "A's" except "Ask", which was consistently high.

Conclusions:

• Physician training can substantially improve compliance with PHS tobacco cessation guidelines.
• The intervention demonstrated effectiveness in enhancing the delivery of smoking cessation services.