The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62010

Myra A. Crawford, PhD, MPH¹, Lesa L. Woodby, PhD, MPH², Tamela J. Turner, PhD, MEd, MCn¹, and Jean Marie White, BA¹. (1) Department of Family & Community Medicine, University of Alabama at Birmingham, 930 South 20th Street, Room 325, Birmingham, AL 35205, (205) 934-9376, jwhite@fms.uab.edu, (2) Birmingham VA Medical Center-GRECC and UAB Family and Community Medicine, University of Alabama at Birmingham, 930 20th Street South, 371 CH20, Birmingham, AL 35294-2042

Background: Recent studies support the impact of healthcare providers’ advice to patients on quitting smoking, yet indications are that few are aware of, or utilize, the national guidelines on this topic. Purpose: To conduct an assessment of current physician practices related to smoking cessation counseling, and to develop a training program adaptable to multiple disciplines. Methods: A brief survey was faxed to 1,196 primary care providers in Alabama (family physicians, obstetricians, internists and pediatricians). 259 (22%) responded; 117 family physicians, 69 internists, 24 obstetricians and 49 pediatricians. Results: Self-rated consistencies of evidence-based tobacco use assessment and counseling elements (the 5-As) and familiarity with national guidelines revealed that, of physicians surveyed, an average of 66% always ask patients if they smoke; 79% always advise smokers to quit; 41% always assess smokers’ willingness to quit; and 45% always assist smokers in quit attempt(s). One third (29%) always arrange follow-up for patients who want to quit; 40% always provide counseling and 25% provide information, such as pamphlets. Almost a third (27%) always recommend pharmacotherapy, usually bupropion or patch. Only 19% were familiar with the Clinical Practice Guideline on Smoking Cessation; 16% had previously participated in smoking cessation CME; 76% were willing to participate in such a program. Conclusions: This survey indicated a need for and interest in smoking cessation CME among physicians. ATOFF designed two training programs for healthcare providers based on the Guidelines / 5-A model, and, in the first year, trained over 1,000 healthcare providers throughout the state.

Learning Objectives:

At the conclusion of the session, participants should be able to:
• Identify best-practice tobacco cessation guidelines and 5-A model.
• Articulate the importance of primary care providers being informed about the guidelines and using them in their assessment and counseling encounters with patients who smoke.
• Understand the necessary components of a smoking cessation counseling program for healthcare providers.

Keywords: Smoking Cessation, Evidence Based Practice

Related Web page: www.atoff.net

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Alabama Tobacco Free Families (ATOFF) University of Alabama at Birmingham Department of Family & Community Medicine Division of Research
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Grants, employment