Prevalence and correlates of receipt by smokers of general practitioner advice on smoking cessation in England: a cross-sectional survey of adults

Addiction. 2021 Feb;116(2):358-372. doi: 10.1111/add.15187. Epub 2020 Jul 24.

Abstract

Background and aims: Advice from a general practitioner (GP) can encourage smokers to quit. This study aimed to estimate the prevalence and correlates of receipt of GP advice on smoking, what type of advice and support was offered and characteristics and quitting activity associated with different types of advice.

Design/setting: Data were collected between 2016 and 2019 in a series of monthly cross-sectional surveys of representative samples of the adult population in England.

Participants: A total of 11 588 past-year smokers.

Measurements: Participants reported whether they had received advice or offer of support for smoking cessation from their GP in the last year. Socio-demographic and behavioural characteristics and past-year quit attempts and cessation were also recorded.

Findings: One in two [47.2%, 95% confidence interval (CI) = 46.1-48.3%] past-year smokers who reported visiting their GP in the last year recalled receiving advice on smoking, and one in three (30.1%, 95% CI = 29.1-31.1%) reported being offered cessation support. The most common form of support offered was stop smoking services (16.5%, 95% CI = 15.7-17.3%) followed by prescription medication (8.1%, 95% CI = 7.5-8.7%); 3.7% (95% CI = 3.3-4.1%) reported having been recommended to use e-cigarettes. Smokers who were older, non-white, more addicted, and smoked five or more cigarettes/day had consistently higher odds of receiving advice or support. There were some differences by region, housing tenure, presence of children in the home and high-risk drinking in the types of advice/support received. There were no significant differences by sex, occupational social grade, disability, type of cigarettes smoked, or survey year. Advice with any offer of support was associated with higher odds of attempting to quit than advice alone [adjusted odds ratio (ORadj ) = 1.52, 95% CI = 1.30-1.76]. Advice alone was associated with higher odds of quit attempts than no advice in smokers with higher (ORadj = 1.34, 95% CI = 1.10-1.64) but not lower occupational social grade (ORadj = 0.90, 95% CI = 0.75-1.08).

Conclusions: In England, a minority of smokers receive support from their GP to stop smoking. Those who do are more likely to be older, non-white and more addicted to cigarettes. Advice plus offer of support appears to be associated with increased odds of making a quit attempt, while advice without offer of support appears only to be associated with increased odds of making a quit attempt in higher occupational social grade smokers.

Keywords: Brief advice; GP advice; general practice; quit attempts; smoking cessation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcohol Drinking / epidemiology
  • Counseling / statistics & numerical data*
  • Cross-Sectional Studies
  • England / epidemiology
  • Female
  • General Practitioners / statistics & numerical data*
  • Health Behavior
  • Housing
  • Humans
  • Male
  • Middle Aged
  • Practice Patterns, Physicians'
  • Prevalence
  • Smoking / epidemiology*
  • Smoking Cessation / statistics & numerical data*
  • Surveys and Questionnaires
  • Young Adult