Physicians taught as residents to conduct smoking cessation intervention: a follow-up study

Prev Med. 2004 Aug;39(2):344-50. doi: 10.1016/j.ypmed.2004.01.027.


Background: The influence of residency training on use of smoking cessation intervention (SCI) in future practice is unexamined.

Methods: We surveyed 291 physicians who participated in SCI research during residency between 1986 and 1996. Half received SCI training; half did not. Best practice included: (1) identifying smokers; (2) advising cessation; (3) assisting with a plan; (4) arranging follow-up.

Results: Forty-two percent of respondents were using best practices. Training per se was not associated with current use of best practices (relative risk = 1.04; adjusted relative risk [ARR] = 0.91). However, those who reported use of best practices in residency were twice as likely to currently use best practices [ARR = 2.0; 95% confidence interval (CI) 1.3, 2.9]. Resources associated with use of best practices included patient education materials (ARR = 1.8; CI 1.1, 2.7), staff familiar with SCI (ARR = 1.8; CI 1.2, 2.6), and opportunity for referral to cessation counselors/programs (ARR = 1.3; CI 1.0, 1.9). Resources related in a dose-response fashion to best practices: 24% of those without resources provide best SCI, 32% with any one resource, 51% with any two, and 74% with all three.

Conclusions: To expand use of best SCI, residencies must ensure physicians use SCI skills, and health care systems must provide resources to facilitate intervention.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cohort Studies
  • Education, Medical*
  • Follow-Up Studies
  • Humans
  • Internship and Residency
  • Physicians
  • Professional Practice / standards
  • Professional Practice / statistics & numerical data*
  • Smoking Cessation / methods*
  • Surveys and Questionnaires