Comparison of patients' and their resident physicians' responses regarding smoking-cessation interventions

To investigate (1) the extent of agreement between what resident physicians and their patients report as having occurred in physician-delivered smoking interventions and (2) the ability of residents to effectively transmit information concerning smoking interventions to their patients.

A total of 263 patients and 91 residents in internal medicine or family practice completed paper-and-pencil exit interviews after a regularly scheduled clinic appointment between 1986 and 1988 at the University of Massachusetts Medical School; the residents had been trained to deliver counseling interventions. The kappa statistic was used as an index of chance-corrected agreement between the patients' and residents' responses.

Agreement was substantial regarding whether a specific plan for the patient to stop or reduce smoking was agreed upon, whether written materials on how to quit smoking were provided, and whether nicotine-containing chewing gum was prescribed.

There was positive agreement between the patients and their resident physicians concerning the residents' delivery of quit-smoking messages and the provision of written materials to assist in stopping. Programs must continue to be designed, for residents and for more senior physicians, so that physicians can be encouraged to incorporate smoking interventions into their practice activities.