Correlates of tobacco cessation counseling among Hispanic physicians in the US: A cross-sectional survey study

Abstract

BackgroundPhysician advice is an important motivator for attempting to stop smoking. However, physicians' lack of intervention with smokers has only modestly improved in the last decade. Although the literature includes extensive research in the area of the smoking intervention practices of clinicians, few studies have focused on Hispanic physicians. The purpose of this study was to explore the correlates of tobacco cessation counseling practices among Hispanic physicians in the US.MethodsData were collected through a validated survey instrument among a cross-sectional sample of self-reported Hispanic physicians practicing in New Mexico, and who were members of the New Mexico Hispanic Medical Society in the year 2001. Domains of interest included counseling practices, self-efficacy, attitudes/responsibility, and knowledge/skills. Returned surveys were analyzed to obtain frequencies and descriptive statistics for each survey item. Other analyses included: bivariate Pearson's correlation, factorial ANOVAs, and multiple linear regressions.ResultsRespondents (n = 45) reported a low level of compliance with tobacco control guidelines and recommendations. Results indicate that physicians' familiarity with standard cessation protocols has a significant effect on their tobacco-related practices (r = .35, variance shared = 12%). Self-efficacy and gender were both significantly correlated to tobacco related practices (r = .42, variance shared = 17%). A significant correlation was also found between self-efficacy and knowledge/skills (r = .60, variance shared = 36%). Attitudes/responsibility was not significantly correlated with any of the other measures.ConclusionMore resources should be dedicated to training Hispanic physicians in tobacco intervention. Training may facilitate practice by increasing knowledge, developing skills and, ultimately, enhancing feelings of self-efficacy.

Use of Smoking Cessation Interventions by Physicians in Argentina

“…This finding is consistent with other studies conducted in Argentina (Gigliotti et al, 2013; Mejia et al, 2010), as well as in the US (Huang et al, 2013; Sadowski et al, 2009; Soto Mas et al, 2008). Given the evidence that supports use of physician-implemented smoking cessation interventions, this reinforces the need to standardize and strengthen training in the medical school curricula as well in the residency programs.…”

“…Interestingly, unlike other studies, physicians who were current smokers were not less likely to use cessation components and are similar to findings from a US study. (Soto Mas et al, 2005; Soto Mas et al, 2008) The most frequently identified barriers to implementing cessation interventions were lack of time and lack of training that is similar to those reported by others (Blumenthal, 2007; Kaplan et al, 2004) and this was associated with decrease likelihood of arranging follow-up.…”

“…The main predictors of physician-implemented smoking cessation interventions were specific training (Huang et al, 2013; Sadowski, Ruffieux, & Cornuz, 2009; Soto Mas et al, 2008) (Schnoll, Rukstalis, Wileyto, & Shields, 2006; Twardella & Brenner, 2005; Zhou et al, 2010), clinician self-efficacy (Sadowski et al, 2009; Soto Mas et al, 2008) (Schnoll et al, 2006), and younger physician age (Schnoll et al, 2006). Physician smoking status was a negative predictor of cessation success in several studies (Huang et al, 2013; Juliao et al, 2013; Ng et al, 2007; Noble, Perez Stable, & Casal, 1996; Pipe et al, 2009; Ulbricht et al, 2009), but it showed no effect on others (Gigliotti et al, 2013; Sadowski et al, 2009).…”

“…Physician smoking status was a negative predictor of cessation success in several studies (Huang et al, 2013; Juliao et al, 2013; Ng et al, 2007; Noble, Perez Stable, & Casal, 1996; Pipe et al, 2009; Ulbricht et al, 2009), but it showed no effect on others (Gigliotti et al, 2013; Sadowski et al, 2009). Physician gender has also shown conflicting results (Frank & Harvey, 1996;Soto Mas et al, 2005; Soto Mas et al, 2008; Zhou et al, 2010). Studies indicated that primary care physicians were more likely to implement cessation interventions with their patients compared to specialists (Kaplan et al, 2004; Perez-Stable et al, 2001).…”

Health Care Workers in the Dominican Republic: Self-Perceived Role in Smoking Cessation

“…Based on the clinical guidelines for Treating Tobacco Use and Dependence (Fiore, 2000) recommended cessation intervention five A’s (ask, advise, assess, assist, arrange), among Cuban physicians, only a third “asked” and only 38% provided “advice” to smokers (Varona et al). A survey of 45 Hispanic physicians practicing in New Mexico (Soto Mas, Balcazar, Valderrama Alberola & Hsu, 2008) demonstrated a low level of compliance with tobacco control guidelines.…”