The 13th World Conference on Tobacco OR Health

Objective: Much study has been devoted to identifying patients at risk for persistent smoking. Few studies have examined whether physicians have responded to these patients. This study examines physician advice about smoking from 2000-2004 in Ontario, Canada.

Methods: Data from the CAMH-Monitor, an annual cross-sectional RDD survey of Ontario adults, were compiled from 2000 to 2004 (response rate =60%). During this period, 3076 current smokers were surveyed about their smoking behavior, quit attempts and experiences with physicians. Logistic regression was used to compare characteristics of those who received physician advice and those who did not.

Results: Advice to quit smoking remained low throughout the five-year period, with a maximum of 53% [95% CI: 47.5%, 58.4%] of current smokers in 2004. Daily smokers, and those intending to quit were significantly more likely to report having been advised to quit (p<0.001). These groups of were also more likely to be recommended NRT and bupropion, and been asked to set a quit date (p<0.001). However, none of these relationships changed significantly over time with fewer than half of respondents reporting being recommended each quit aid or method. Over the five years, patients with less than high school were increasingly likely to be advised to stop smoking than those with university degrees (p=0.016). Females were increasingly more likely to be recommended counselling, and older patients were more likely to be recommended pharmacotherapy (p<0.001).

As physicians remain the most likely health professional from which smokers seek advice, increased emphasis needs to be placed on training in smoking cessation.