Smoking cessation and counseling: practices of Canadian physical therapists

Although engaging or supporting smoking cessation with patients is a health priority for health professionals, the degree to which physical therapists do so is unknown. They have a particular responsibility given their professional commitment to patient education, and typical practice pattern (i.e., long, multiple visits).

This study examined the smoking-cessation practices of Canadian physical therapists, including the frequency of such counseling; use of the established 5A's approach (ask, advise, assist, assess, and arrange follow-up); and smoking-cessation training received.

A cross-sectional postal survey of licensed practicing physical therapists in Canada was conducted. Surveys were mailed between April and June 2009 and data analyzed in November 2009. Descriptive statistics characterized their sociodemographics and counseling practices; chi-square assessed differences between those trained in smoking-cessation counseling trained and those untrained for the 5A's, and regional differences for smoking- cessation counseling frequency and training.

Completed surveys (n=738) yielded a 78.1% response rate. Most physical therapists (54.0%) counsel rarely or not at all. Regional differences for smoking-cessation counseling were observed. In all, 76.3% asked their patients if they smoke, but few (21.6%) reported assisting their patients to quit smoking. Few reported receiving smoking-cessation counseling training; proportionally, those trained in smoking-cessation counseling assisted, assessed, and arranged follow-ups more than those who were untrained.

Few Canadian physical therapists (25.4%) counsel for smoking cessation all or most times, or adhere to the established 5A's approach. Smoking-cessation counseling training including the 5A's needs to be included in physical therapy continuing education and the curricula in entry-level programs, consistent with 21st-century health priorities.