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.
