Global Surveys Reveal a Serious Communication Gap Between Doctors and Smokers



    There is a significant communication gap between doctors and their
    smoking patients, according to combined results from two of the
    largest international surveys of physicians' and smokers' attitudes to
    smoking and smoking cessation. Results showed that there are
    significant differences between doctors' smoking cessation practices
    and smokers' experiences.

    Both doctors and smokers acknowledge the harmful effects of
    smoking and the importance of quitting. A majority of physicians (69%)
    believe that smoking is the most harmful activity to affect their
    patients' long-term health compared with lack of exercise (42%),
    unhealthy diet (36%), drinking alcohol (30%) and over-eating/obesity
    (23%). Similarly, most smokers (75%) are concerned about the health
    risks of smoking and the majority (81%) agree that quitting smoking is
    the best way to improve their health.

    Advice from a healthcare professional, even when brief, is known
    to increase the success of smokers wanting to quit(1). Despite this,
    the surveys highlight a vast difference in the number of doctors (41%)
    who say they discuss smoking with their patients at every visit,
    versus the number of smokers (9%) who say they discuss smoking with
    their doctor at every visit.

    Although 66% of doctors said they explain various methods of
    quitting to their patients, only half of this total of smokers who
    have talked to a doctor about smoking (33%) said they received this
    advice. In addition, although 47% of doctors stated that they develop
    quit plans for their patients to assist them, only a quarter of this
    total of smokers who have talked to a doctor about smoking (13%) said
    this was the case.

    "These surveys provide valuable insight into the need for improved
    communication between smokers and doctors," said Hayden McRobbie,
    Clinical Trials Research Unit, University of Auckland, New Zealand.
    "Although smokers know that quitting smoking is the single biggest
    step to improving their health, these surveys show that patients do
    not often believe they are receiving the support and advice from their
    doctor that is vital to successfully quit smoking."

    Smoking is a chronic, relapsing medical condition that involves a
    physical and psychological addiction to nicotine. According to the
    World Health Organization, less than 5% who attempt to quit unaided
    remain smoke free at one year.(2) Even with assistance, quitting
    smoking is still difficult. Indeed, 56% of smokers who have tried to
    quit said that it is the hardest thing they have ever tried to do.

    Both physicians and smokers believe that it is the smoker who is
    most responsible for quitting and that individual willpower is vitally
    important to a successful quit attempt. Ninety-two percent of
    physicians think quitting is primarily up to individual willpower and
    91% of smokers agreed. Yet willpower alone is usually an ineffective
    method to quit, as a large percentage of doctors (who smoke and tried
    to quit) (58%) and smokers (81%) have failed to quit smoking using
    willpower alone.

    The surveys also highlighted that doctors need better support,
    resources and improved training to engage patients. Data from the
    surveys showed that doctors want effective smoking cessation
    medications (81%) and additional coaching on motivating their patients
    to quit (78%). Data from the surveys also showed 51% of doctors said
    they do not have time to help their patients quit, 46% said they had
    higher priorities and 38% said they were not appropriately trained to
    help patients quit smoking.

    "Although governments are taking steps to curb smoking by
    initiating smoke-free policies, there needs to be more support from
    doctors for smokers trying to quit," said Serena Tonstad Department of
    Preventive Cardiology, Ulleval University Hospital, Norway "We need to
    call upon doctors around the world to give appropriate advice and
    support to patients wanting to quit smoking."

    About The Surveys:

    STOP

    STOP (Smoking: The Opinion of Physicians) survey, sponsored by
    Pfizer and conducted by Harris Interactive Inc, is one of the largest
    global surveys examining the attitudes towards smoking and smoking
    cessation of general practitioners and family physicians - including
    both smokers and non-smokers. 2,836 physicians from 16 countries were
    interviewed for the study. Physicians in Canada, France, Germany,
    Greece, Italy, Japan, Korea, Mexico, Netherlands, Poland, Spain,
    Sweden, Switzerland, Turkey, UK and US participated in the survey. The
    survey fieldwork was conducted between May and June 2006. STOP was
    funded by Pfizer.

    SUPPORT

    SUPPORT (Smoking: Understanding People's Perceptions, Opinions and
    Reactions to Tobacco), sponsored by Pfizer and conducted by Harris
    Interactive, is one of the largest global surveys conducted to
    investigate the attitudes and behaviours of smokers towards smoking
    and smoking cessation. 3,760 adult smokers aged 25+ from 15 countries
    were interviewed for the study. Smokers in Canada, France, Germany,
    Italy, Japan, Mexico, Netherlands, Poland, Portugal, Spain, South
    Korea, Sweden, Turkey, UK and US participated in the survey. The
    survey fieldwork was conducted between August and September 2006 and
    Dec and Jan 2007. SUPPORT was funded by Pfizer.

    For the SUPPORT survey, in Europe, the figures of age, sex,
    education, region, number of adults in the household, and number of
    phone lines in the household were weighted where necessary to bring
    them into line with their actual proportions in the population. In
    Japan age, sex, education, income, martial status, region, and number
    of phone lines in the household were used. In South Korea, age, sex,
    education, income, region, and number of phone lines the household
    were used. In Canada age, sex, education, income, language, region,
    race/ethnicity, and number of adults in the household, and number of
    phone lines in the household were used. In Mexico, age, sex,
    education, socioeconomic status, state, and number of phone lines the
    household were used. In the U.S., age, sex, education, income,
    race/ethnicity, region, number of adults in the household and number
    of phone lines the household were used . With a pure probability
    sample of 3,760 for the SUPPORT survey, one could say with a
    ninety-five percent probability that the overall results would have a
    sampling error of +/- 2 percentage points. Sampling error for data
    based on sub-samples would be higher and would vary. However, that
    does not take other sources of error into account.

    About the Spokespeople

    -- Hayden McRobbie, MD, ChB, Research Fellow at the Clinical
    Trials Research Unit at the University of Auckland, New
    Zealand, and a varenicline clinical trial investigator.

    -- Serena Tonstad, MD, PhD, Head Physician at the Department of
    Preventive Cardiology, Ulleval University Hospital, Norway,
    and a varenicline clinical trial investigator.

    References

    1. World Health Organization. New survey shows lack of training on
    tobacco cessation techniques for health-profession students.
    31 May 2005: World No Tobacco Day. Available online at URL:
    http://www.who.int. Last accessed February 20072. WHO European
    Strategy for Smoking Cessation Policy. Available online at
    URL: http://www.euro.who.int/Document/E80056.pdf Last accessed
    February 2007.