Physician smoking status, attitudes toward smoking, and cessation advice to patients: An international survey

Objective: The smoking status of physicians can impact interactions with patients about smoking. The 'Smoking: The Opinions of Physicians' (STOP) survey examined whether an association existed between physician smoking status and beliefs about smoking and cessation and a physician's clinical interactions with patients relevant to smoking cessation, and perceptions of barriers to assisting with quitting. Methods: General and family practitioners across 16 countries were surveyed via telephone or face-to-face interviews using a convenience-sample methodology. Physician smoking status was self-reported. Results: Of 4473 physicians invited. 2836 (63%) participated in the survey, 1200 (42%) of whom were smokers. Significantly fewer smoking than non-smoking physicians volunteered that smoking was a harmful activity (64% vs 77%; P < 0.001). More non-smokers agreed that smoking cessation was the single biggest step to improving health (88% vs 82%; P < 0.001) and discussed smoking at every visit (45% vs 34%; P < 0.001). Although more non-smoking physicians identified willpower (37% vs 32%; P < 0.001) and lack of interest (28% vs 22%; P < 0.001) as barriers to quitting, more smoking physicians saw stress as a barrier (16% vs 10%; P < 0.001). Conclusion: Smoking physicians are less likely to initiate cessation interventions. Practice implications: There is a need for specific strategies to encourage smoking physicians to quit, and to motivate all practitioners to adopt systematic approaches to assisting with smoking cessation. (c) 2008 Elsevier Ireland Ltd. All rights reserved.