Smoking cessation counselling: impact of chart stickers and resident training

Abstract

Objectives: To assess the effect of a training program for smoking cessation combined with chart stickers on resident's (physicians-in-training) practice of counselling smoking patients.

Setting: A single centre prospective observational study at the Basel University Hospital Medical Outpatient Department.

Methods: 456 consecutive outpatients were contacted by phone within 24 hours of their initial consultation. Information concerning questions asked about smoking and/or cessation advice provided by the resident to patients was collected and compared with a historical pre-interventional cohort using the identical questionnaire and study design.

Results: Of 272 patients included, 106 (39%) were current smokers, 123 (45%) had never smoked, and 43 (16%) were former smokers. The mean age was 43 +/- 11 (range 16-87) years and 49% were male. Equal proportions of participants were in the pre-contemplation (40%) and contemplation stages (42%), 16% were preparing to quit and 2% had stopped in the previous 6 months. Results related to smoking cessation advice were compared to those obtained during an identical survey one year earlier performed prior to the intervention (pre-interventional). Residents questioned 82% (pre-interventional 81%) of the patients about smoking and inquired about smoking duration in 71% (pre-interventional 44%) of the patients. 46% (pre-interventional 28%) of the patients received information on smoking-related risks, whereas cessation was discussed with 32% (pre-interventional 10%) and offered to 23% (pre-interventional 9%) of the patients.

Conclusion: Compared with a historical pre-interventional cohort, the rates of patients receiving appropriate counselling approximately doubled following the introduction of systematic training on smoking cessation and chart labels. Extended regular training for physicians on smoking-related issues may have a potentially beneficial effect in improving counselling of smokers and meeting the global tobacco challenge.