Short report. Do patient age and medical condition influence medical advice to stop smoking?

Abstract

Objective: to determine whether the age and medical condition of a patient influences hospital-based doctors' decision making when advising patients to stop smoking cigarettes. Methods: we presented 142 doctors from four grades (consultant, registrar, senior house officer and house officer) and four specialities (medicine, surgery, psychiatry and anaesthetics), based in a Dublin teaching hospital, with 20 clinical vignettes. Each vignette described a patient from one of five age groups with one of four levels of health. The vignettes were randomly mixed. We asked doctors to say whether they would advise the patient in each case to quit smoking. Results: hospital-based doctors are significantly less likely to advise patients aged over 65 years than younger patients of the hazards of cigarette smoking, irrespective of the person's physical or mental health (P < 0.001). Conclusion: the advice given to patients about their cigarette smoking habits by hospital doctors is strongly influenced not only by the patient's health, but also by the patient's chronological age.

Predictors of Smoking Patterns After First Stroke

“…In other words, as suggested by the literature (e.g., Buckland & Connolly, 2005; Gall, Dewey, & Thrift, 2009; Lawrence, Kerr, Watson, & Ellis, 2010; Maguire, et al, 2000), medical and allied health care providers may not be capitalizing on “teachable moments” to the full extent that they could.…”

“…Maguire, et al (2000) found that, irrespective of an individual’s physical or mental health, hospital-based physicians were significantly less likely to advise patients over the age of 65 years old to quit smoking. This is problematic considering that about three-quarters of all strokes occur in people over the age of 65 (Centers for Disease Control, 2011).…”

“…However, conclusions should be drawn with caution given that existing studies are based on relatively small convenience samples (e.g., Buckland & Connolly, 2005; N = 100 ; Gall, Dewey, & Thrift, 2009; N = 40 ; Maguire, et al, 2000, N = 142 ; Lawrence, Kerr, Watson, & Ellis, 2010, N = 49 ). More importantly, existing research focused primarily on the role of physicians in smoking cessation after chronic illness does not reflect the multitude of allied healthcare providers, each with opportunities to capitalize on teachable moments, that stroke survivors interact with during inpatient hospitalization.…”

Tobacco smoking in older people

“…So, for older people the likelihood of having a serious smokingrelated illness that provides the trigger for strong encouragement to quit is far higher than for the young, and offers healthcare workers, including doctors, a chance to help their older patients to stop smoking that is known to be effective. 46 On the other hand, evidence from North American studies suggests that older smokers are as likely as younger smokers to respond to a targeted smoking cessation campaign, including brief intervention in a primary care setting. Unfortunately, there is evidence that elderly smokers in the UK and USA are far less likely to receive smoking cessation advice from their primary care doctors compared with younger patients, despite the fact that they consult more frequently.…”

Two-Year Outcomes From a Cessation of Smoking Intervention in Older Adults

“…Further, older patients are less likely to receive cessation counselling or advice (Maguire et al, 2000;Steinberg, Akincigil, Delnevo, Crystal, & Carson, 2006), although they generally welcome such advice (OssipKlein et al, 2000). Even following acute myocardial infarction, only 40% of older (65 years or above) smokers receive counselling on cessation of smoking (Brown et al, 2004), despite its well-established benefits (Wilson, Gibson, Willan, & Cook, 2000).…”