5152.0: Wednesday, November 15, 2000 - 12:30 PM

Abstract #12588

Individual and contextual factors related to family practice residents' assessment and counseling for tobacco cessation

Nell H. Gottlieb, PhD1, Jong-Long Guo, MEd1, Shelley A. Blozis, PhD2, and Philip P. Huang, MD, MPH3. (1) Dept. of Kinesiology and Health Education, University of Texas at Austin, Bellmont Hall Rm. 222, Austin, TX 78712, 512-471-8185, ngottlieb@mail.utexas.edu, (2) Dept. of Educational Psychology, University of Texas at Austin, College of Education, Austin, TX 78712, (3) Bureau of Disease, Injury and Tobacco Prevention, Texas Department of Health, 1100 West 49th Street, Austin, TX 78759

Tobacco use is the chief avoidable cause of death in the United States. However, physicians are not routinely assessing this risk and providing counseling for risk reduction. This study examines tobacco cessation counseling practices among family practice residents and explores the determinants of residents' smoking counseling behaviors and counseling duration. One hundred and ten family practice residents (response rate=93.2%) from four clinics that received funding from the Texas Department of Health completed a survey designed to assess tobacco cessation counseling practices. A high proportion of residents reported that they usually or always assessed tobacco use (59.3%) and advised their patients to quit smoking (80.9%). They were less likely to provide specific counseling behaviors, referrals or follow-ups. Only 21.9% of residents reported they usually or always advised patients to set a quit date; 17.2%, prepared them for withdrawal symptoms; 15.4%, provided self-help materials; 7.4%, prescribed nicotine replacement; 1.8%, referred patients to a group; and 1.8%, called or had staff follow-up after the quit date. Overall, 11.1% reported counseling patients an average of 10 minutes or more. Year of residency, perceived effectiveness and the interaction between perceived effectiveness and residency year were significantly associated with number of counseling behaviors, and year of residency and perceived effectiveness, with counseling duration. Perceived effectiveness and residency year were the only determinants to influence both smoking counseling and duration. On average, residents in year 3 provided more smoking counseling and counseled for a longer duration than those in their first year.

Learning Objectives: 1. Describe the importance of family practice physicians in tobacco control. 2. Identify the proportion of Texas family practice residents who assess, counsel, and refer their smoking patients to cessation programs. 3. Recognize that perceived effectiveness and residency year are significant determinants of the number of counseling behavior and counseling duration of residents. 4. Describe interventions to increase smoking assessment, counseling and referral by family practice physicians

Keywords: Tobacco Control, Clinical Prevention Services

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA