The association between patient-reported receipt of tobacco intervention at a primary care visit and smokers' satisfaction with their health care

Abstract

U.S. Public Health Service (USPHS) clinical guidelines for tobacco treatment recommend that providers routinely counsel smokers using a five-step algorithm (5A's): ask about tobacco use, advise smokers to quit, assess interest in quitting, assist with treatment, and arrange follow-up. A potential barrier to compliance is providers' concern that addressing smoking might alienate smokers, especially those not ready to quit. A survey was mailed to 1,985 patients seen at one of eight Boston-area primary care practices from January 1 to March 31, 2003, and identified as smokers by chart review. The survey assessed respondents' receipt of the 5A's at their visit and their satisfaction with the provider's tobacco treatment and with their overall health care. We used multivariable logistic regression models to assess the association between satisfaction with care and patient-reported receipt of each 5A step, adjusted for age, sex, education, race, health status, smoking intensity, readiness to quit, and length of relationship with provider. Of 1,160 respondents (58% response rate), 765 reported that they smoked at the time of the visit. They reported high levels of satisfaction with their tobacco-related care and overall care. Patient-reported receipt of each 5A step was significantly associated with greater patient satisfaction with tobacco-related care and with overall health care, even after adjusting for a smoker's readiness to quit smoking. Satisfaction with overall health care increased as counseling intensity increased. Patient reports of smoking cessation interventions delivered during primary care practice are associated with greater patient satisfaction with their health care, even among smokers not ready to quit. Providers can follow USPHS guidelines with smokers without fear of alienating those not yet considering quitting.

Predictors of Success for Smoking Cessation at the Workplace: A Longitudinal Study

“…Moreover, allowing personal needs and preferences to guide pharmacological support may increase efficacy [25]. Accordingly, a change in addictive behaviour may also relate to personal skills and capacities [26,27]. …”

The Role of Health Care Systems in Increased Tobacco Cessation

“…When health care providers discuss tobacco use with their patients who smoke and when they recommend treatment and follow up with them, it increases patients' satisfaction with their health care (18,76). Patients should expect that tobacco use will be addressed as part of routine health care-and if it is not, patients should understand that they are not receiving high-quality, comprehensive health care.…”

Psychologists and Smoking Cessation Intervention: Unrealised Potential

“…As has been found in surveys of mental health professionals in other contexts (Wye et al, 2009;Wye et al, 2010) this study identified a concern about the receptivity of clients to smoking cessation intervention, although such concerns are not likely to be well-founded (Conroy et al, 2005;Fiore et al, 2008;Moeller-Saxone, 2008). Training and education for psychologists may assist in dispelling some of the myths and misperceptions around the desire and need of smokers for assistance to quit, as well as reinforcing smoking as a legitimate clinical concern and cessation as a treatment goal of high priority.…”