Promotion of smoke-free environments in clinical practice

Objective: In order to reduce exposure to secondhand smoke (SHS), it is important to promote cessation services in clinical practice. This study describes referral to smoking cessation services and advice to reduce SHS exposure practices. Methods: The physician sample consisted of family/general practitioners, internists and obstetrician/gynecologists using data from the 2010 DocStyles survey. The sample was an Epocrates Honor Panel, an opt-in, verified panel of physicians (using first and last name, date of birth, medical school and graduation date). Physicians were asked about frequency of referral and strategies to aid with avoiding SHS. Results: Female physicians were more likely than male physicians to regularly refer their patients to smoking cessation services [OR=1.73, 95% CI 1.19-2.51]. Those who regularly referred to smoking cessation services were more likely to be in group practice than individual practice [OR=1.52, 95% CI 1.03-2.25]. Physicians who regularly referred to smoking cessation services were less likely to be obstetrician/gynecologists than family/general practitioners [OR=0.53, 95% CI 0.35-0.80]. Data showed that 93.6% of physicians advised patients with children to protect against SHS exposure, 85.5% advised patients who smoke or use other tobacco products to create smoke-free homes and cars, and 71.9% advised non-tobacco users to avoid being exposed to SHS. Conclusions: Physicians play a key role in promoting smoking cessation services and reducing exposure to SHS. Further work is needed to emphasize the U.S. Preventive Services Task Force recommendations to reduce the level of exposure to tobacco smoke.