Physician counseling for smoking cessation: is the glass half empty?

Professional groups urge physicians to aggressively counsel their patients who smoke, but research evaluating the effectiveness of physician counseling has produced mixed results.

Four hundred ten smokers identified in a previous study were contacted 1 year later to determine whether they had quit smoking. In both studies, smokers were asked whether their physicians had counseled them in any of six specific ways (eg, advising the patient of personal health risks and the need to stop smoking, or discussing cessation methods).

Seventy-nine percent of patients reported that their physician counseled them either at the initial visit or at some time during the following year; 42% reported having tried to quit at least once during the year, but only 5.9% were nonsmokers at 1-year follow-up. Physician counseling had no effect on the rate of successful attempts to quit. Patients with serious health problems were more likely to be counseled and to attempt to quit (P < .02). Non-Hispanic white patients were more likely to be counseled but less likely to attempt to quit (P < .01).

Counseling by physicians appears to motivate some patients to attempt to quit, but this study did not show significant improvement in actual quit rates in patients who were counseled by a physician.