Do physicians address their patients' smoking behavior? Results from a nationwide survey among physicians in Estonia

Objectives: To analyze the factors that hinder physicians addressing patients' smoking behavior in Estonia where relatively high smoking among physicians has been previously reported. Study design: Cross-sectional study. Methods: Data from a nationwide cross-sectional postal survey of professionally active physicians in Estonia and multinomial logistic regression were used to explore the factors predicting the frequency (never vs always, often vs always) of addressing patients' smoking behavior. Results: The majority of physicians had asked about the smoking behavior of their patients either always (14.2%) or often (75.7%). Odds of never asking (10.1% of physicians) were higher for dentists, current smokers, and for those reporting lack of time, habit, or skills. Higher odds for less frequent (vs always) asking were found for male physicians, medical residents, and among those reporting lack of time and habit. Conclusions: Addressing patients' smoking behavior is associated with physicians' demographic characteristics, specialty, and smoking status. Also, lack of time, habits, and skills are common barriers that need to be tackled for more efficient smoking cessation counseling. (c) 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.