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

Patient Educ Couns. 2009 Jan;74(1):118-23. doi: 10.1016/j.pec.2008.07.042. Epub 2008 Sep 6.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel*
  • Communication
  • Europe / epidemiology
  • Family Practice / organization & administration*
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Japan / epidemiology
  • Korea / epidemiology
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • North America / epidemiology
  • Patient Education as Topic / organization & administration*
  • Physician's Role / psychology
  • Physician-Patient Relations
  • Physicians, Family / education
  • Physicians, Family / organization & administration
  • Physicians, Family / psychology
  • Practice Patterns, Physicians' / organization & administration*
  • Qualitative Research
  • Smoking Cessation / psychology
  • Smoking Prevention
  • Smoking* / epidemiology
  • Smoking* / psychology
  • Surveys and Questionnaires
  • Turkey / epidemiology