Practice patterns and training for tobacco cessation for three types of complementary and alternative medicine practitioners

Objectives: The purpose of the study was to characterize practice patterns and tobacco cessation training for three types of complementary and alternative medicine (CAM) practitioners (acupuncture/Traditional Chinese Medicine [TCM], chiropractic, and massage). Methods: Researchers administered a mail survey to all licensed acupuncturist, chiropractors, and massage therapists in Tucson, Arizona. N=356 practitioners responded (acupuncturists, n=63, chiropractors, n=56, massage therapists, n=237). Results: Most respondents practice more than one CAM modality (mean 2.6, SD 1.9) with acupuncturists practicing 4.8 (SD 1.9), chiropractors, 2.9 (SD 1.9) and massage therapists, 2.0 (SD 1.4). For example, over 50% of acupuncturists report using herbs, energy therapies, and nutritional counseling in practice. When asked if they had training in tobacco cessation, 64.5% report none. Respondents who report training, 19.9% had professional training (73% acupuncturists, 18% chiropractors, 7% massage therapists), 17.3% learned on their own (36% acupuncturists, 15% chiropractors, 4% massage therapists) and 11.1% received continuing education training (37% acupuncturists, 13% chiropractors, 13% massage therapists). When asked how often they ask new clients about tobacco use, 77% of acupuncturists report always, compared to 58% of chiropractors and 17% of massage therapists. When asked how often they advise clients to quit tobacco, 44% of acupuncturists report always compared to 34% of chiropractors and 9% of massage therapists. Results: CAM practitioners in Tucson, AZ identify with a primary modality; however they often use multiple modalities. Most respondents report no formal tobacco cessation training and many do not ask clients about tobacco use. This suggests an opportunity for training and practice modification.