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

Abstract #64896

Lorena Rodriguez Chandler, School of Public Health, University of California, Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, 562-421-3456, lorena.chandler@phs.com

Interventions targeting pregnant women at the physician level have been effective in doubling, if not tripling quit rates. Physician advice to quit smoking is noted as one of the most important motivators in a smoker’s decision to quit, and a brief cessation counseling session coupled with educational materials can significantly increase cessation rates. A questionnaire was mailed to 400 Obstetrician/ Gynecologists in California. A representative sample of 24 physicians returned the survey, which was based on the 4-A model of smoking cessation counseling (Ask, Advise, Assist and Arrange). Findings were compared to a similar study conducted by Zapka et al, 2000. The main areas that were investigated included smoking intervention practices, knowledge, role perception, effectiveness of counseling, self-efficacy, motivation and organizational facilitators. Consistent with Zapka’s study, physicians in our study scored low in a number of performance measurements. A majority reported they assess smoking (79%) and assist their patients (38%), while a few went beyond to advise patients to quit (17%) or arrange follow-up (8%). Physicians also rated low on the knowledge measurements. A significant negative correlation was found between organizational facilitators and performance. Physicians’ performance was also positively correlated with an increase in self-efficacy. Knowledge, attitude and behavior of physicians are critical, and they can be the prime motivators in persuading their pregnant patients to stop smoking. Mean performance scores signify an opportunity for physicians to improve in all areas; therefore, interventions that encourage detection and counseling as well as training to increase knowledge among OB/Gyn’s will be discussed.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to:
• Apply the 4-A smoking cessation methodology to counsel their patients to quit smoking.
• Analyze their current performance practices as it relates to smoking cessation counseling.
• Integrate simplistic organizational facilitators to enhance smoking cessation counseling with their tobacco-using patients.

Keywords: Pregnancy, Smoking Cessation

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment (PacifiCare Health Plans)