Patient-doctor communication on smoking and drinking: lifestyle in medical consultations

Lifestyles of groups and individuals are significant determinants of the health status of a population. Behaviour with respect to such areas as alcohol, food, drugs, tobacco, physical exercise, etc., correlates with medical and social well-being and are thus on the agenda for modern health care. The present article reports a study of how such lifestyle habits, notably alcohol and tobacco consumption, are addressed in medical consultations. The results indicate that the areas of smoking and drinking are sensitive and that specific communicative strategies are used for introducing these topics and for eliciting information. Smoking habits are addressed in 75% of the consultations and alcohol habits in 30%. In most cases, the information exchanged is shallow and gives only a fragmentary picture of patients' habits. There is little evidence of attempts to influence patients' attitudes and behaviours and the physicians do not contextualise possible relationships between such lifestyle habits and health in the light of their medical knowledge. In this sense, a potentially very influential face-to-face encounter is not used as a vehicle for attempting to eliminate such significant causes of poor health.