Italian General Practitioners and Smoking Cessation Strategies

2003 ◽  
Vol 89 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Anna Maria Pizzo ◽  
Elisabetta Chellini ◽  
Grazia Grazzini ◽  
Antonella Cardone ◽  
Fausto Badellino
Keyword(s):  
Smoking Cessation ◽  
General Practitioners ◽  
Southern Italy ◽  
Collaborative Project ◽  
Family Doctors ◽  
Directorate General ◽  
And Behavior ◽  
Brief Advice ◽  
Gp Training

Aims and Background General practitioners (GPs) are in a key position to intervene with patients who smoke. The cornerstone of a smoking cessation strategy should be the routine provision of brief advice and follow-up in primary care. However, it seems GPs do not often take action against smoking, at least in Italy as shown by previous reports. The survey was planned, in the context of the “GPs Empowerment Project”, a collaborative project involving Denmark, France, Greece, Italy and Portugal, under the ENSP contract with the European Commission (Health & Consumer protection Directorate-General), to evaluate the general attitude, knowledge and behavior of GPs regarding smoking cessation methods. Methods A total of 729 family doctors, 409 in Northern and 320 in Southern Italy, were interviewed by phone in the period July-October 2000 regarding their personal smoking habits and their approach with patients on the topic. Prevalence rates were computed using the Epi INFO 6.0 software and were presented as the unadjusted percentage prevalence. Results The percentage of current smokers among GPs included in the survey was 28.3%, with a higher prevalence in the south (33.3%). Most of the GPs believe that it is their duty to give information about smoking cessation (96.8%) and consider giving information about smoking cessation to their patients an important intervention (98.5%), but only about 49% think their patients will accept their advice. Most GPs (87.3%) declared having discussed about tobacco use with their patients during the month preceding the interview, and 83.5% would like to be trained on smoking cessation strategies. Conclusions The results show that, in order to implement primary prevention in clinical practice in Italy, it appears essential to reduce the number of GPs who smoke and to improve GP training on smoking cessation procedures.

scholarly journals Effectiveness of a motivational intervention based on spirometry results to achieve smoking cessation in primary healthcare patients: randomised, parallel, controlled multicentre study

2021 ◽  
pp. jech-2020-216219
Author(s):  
Francisco Martin-Lujan ◽  
Josep Basora-Gallisa ◽  
Felipe Villalobos ◽  
Nuria Martin-Vergara ◽  
Estefania Aparicio-Llopis ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Respiratory Disease ◽  
Primary Healthcare ◽  
Intervention Group ◽  
Control Group ◽  
Smoking Cessation Advice ◽  
Registration Number ◽  
Brief Advice ◽  
Prolonged Abstinence

ObjectiveThis 12-month study in a primary healthcare network aimed to assess the effectiveness of usual smoking cessation advice compared with personalised information about the spirometry results.DesignRandomised, parallel, controlled, multicentre clinical trial.SettingThis study involved 12 primary healthcare centres (Tarragona, Spain).ParticipantsActive smokers aged 35–70 years, without known respiratory disease. Each participant received brief smoking cessation advice along with a spirometry assessment. Participants with normal results were randomised to the intervention group (IG), including detailed spirometry information at baseline and 6-month follow-up or control group (CG), which was simply informed that their spirometry values were within normal parameters.Main outcomeProlonged abstinence (12 months) validated by expired-CO testing.ResultsSpirometry was normal in 571 patients in 571 patients (45.9% male), 286 allocated to IG and 285 to CG. Baseline characteristics were comparable between the groups. Mean age was 49.8 (SD ±7.78) years and mean cumulative smoking exposure was 29.2 (±18.7) pack-years. Prolonged abstinence was 5.6% (16/286) in the IG, compared with 2.1% (6/285) in the CG (p=0.03); the cumulative abstinence curve was favourable in the IG (HR 1.98; 95% CI 1.29 to 3.04).ConclusionsIn active smokers without known respiratory disease, brief advice plus detailed spirometry information doubled prolonged abstinence rates, compared with brief advice alone, in 12-month follow-up, suggesting a more effective intervention to achieve smoking cessation in primary healthcare.Trial registration numberNCT01194596.

scholarly journals The experience of general practitioners with Very Brief Advice in the treatment of tobacco addiction

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Onno C. P. van Schayck ◽  
Lynn Bindels ◽  
Ancka Nijs ◽  
Bo van Engelen ◽  
Adrienne van den Bosch ◽  
...  
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
General Practitioners ◽  
Premature Death ◽  
Routine Care ◽  
Positive Experience ◽  
Telephone Interviews ◽  
Stop Smoking ◽  
Tobacco Addiction ◽  
Brief Advice

Abstract Although tobacco smoking is the world’s most important preventable cause of many chronic diseases (including COPD and asthma) and premature death, many physicians do not routinely apply smoking cessation in the daily health care of their patients. Two widely felt important concerns of physicians are that smoking cessation as part of a treatment is time-consuming and may jeopardize their relationship with patients. Very Brief Advice (VBA) is a non-confrontational method, which could assist general practitioners (GPs) as a simple, quick first step in getting patients to stop smoking. In this study, we investigated the opinions and experiences of GPs with VBA in their routine care in two rounds of telephone interviews with 19 GPs. The interviews were recorded and transcribed and subsequently analysed with NVivo12. We observed that the GPs had a very positive experience with using VBA. They found the method to be efficient as to the time involved, patient-friendly and easy to implement.

scholarly journals The outpatient medical care in patients with chronic diseases under dispensary supervision in the conditions of the COVID-19 pandemic. Temporary guidelines. Version 2

2022 ◽  
Vol 20 (8) ◽  
pp. 3172
Author(s):  
O. M. Drapkina ◽  
L. Y. Drozdova ◽  
S. N. Avdeev ◽  
S. A. Boytsov ◽  
E. S. Ivanova ◽  
...  
Keyword(s):  
General Practitioners ◽  
Primary Care Physicians ◽  
Communicable Diseases ◽  
Clinical Aspects ◽  
Non Communicable Diseases ◽  
Family Doctors ◽  
National Medical ◽  
Coronavirus Infection ◽  
Overall Mortality

Guidelines were approved at the meeting of the academic council of the National Medical Research Center for Therapy and Preventive Medicine, Moscow (Protocol No. 10 of 19.10.2021).The aim of these guidelines is to provide primary care physicians with scientifically based algorithms for the implementation of dispensary monitoring in patients with chronic non-communicable diseases in the conditions of the new coronavirus infection (COVID-19) pandemic, including the use of telemedicine technologies.The organization and conduct of high-quality medical follow-up are the most important tasks aimed at both reducing the risks of developing complications of chronic non-communicable diseases and reducing overall mortality, especially in the current conditions of the COVID-19 pandemic. The guidelines contain clinical aspects of dispensary follow-up, general principles of tactics for managing patients with various chronic non-communicable diseases in COVID-19 conditions, in addition, brief checklists with options for interviewing patients with various chronic non-communicable diseases are presented, topical aspects of the interaction of drugs used in the treatment of chronic non-communicable diseases with antiviral drugs are considered.The guidelines are intended for general practitioners, district therapists, general practitioners (family doctors), as well as doctors of other specialties providing primary health care.

Increasing Pediatricians’ Smoking Cessation Promotion and Knowledge of the Smoking Cessation Trust

2016 ◽  
Vol 56 (5) ◽  
pp. 461-466 ◽  
Author(s):  
Katharine E. H. Thomas ◽  
Steve Kisely ◽  
Fernando Urrego
Keyword(s):  
Smoking Cessation ◽  
Intervention Group ◽  
Second Hand Smoke ◽  
Health Issues ◽  
Post Intervention ◽  
Second Hand Smoke Exposure ◽  
Baseline Knowledge ◽  
And Behavior ◽  
Short Intervention

The link between second hand smoke exposure (SHSe) and health issues in children has been well established. The objective of this study was to determine if a short intervention implemented among pediatricians promotes improvement in the promotion of smoking cessation to caregivers and increase pediatricians’ awareness of the Smoking Cessation Trust (SCT). Pediatricians from 6 clinics were randomly assigned to the control or intervention group. All pediatricians received a survey to assess baseline knowledge, confidence and behaviors in smoking cessation promotion and utilization of the SCT. Pediatricians in intervention group received an educational lecture delivered by a physician. Two months post intervention, pediatricians in the control and intervention group received a survey to assess changes from baseline. Out of 36 general pediatricians, 27 completed the surveys for use in the analysis of this study (75%). Intervention group made more referrals to the SCT, compared to controls (p=0.048) and to baseline (p=0.0065). Pediatricians in the intervention group were more confident in recommending the use of NRT (0.040) and schedule a follow up to discuss smoking cessation (p=0.029) after the intervention. The intervention group was more likely to refer caregivers to smoking cessation programs (p=0.027), discuss a child’s health risk from SHSe (0.031) and recommending the use of NRT to help quit (p=0.047) post intervention. The results from this study indicate that a short intervention can increase confidence and behavior in various parameters of smoking cessation promotion and significantly improve the rate in which pediatricians refer smoking caregivers to the SCT.

Delivery of a Nicotine Replacement Therapy Sample at Outdoor Smoking Hotspots for Promoting Quit Attempts: A Pilot Randomized Controlled Trial

2019 ◽  
Vol 22 (9) ◽  
pp. 1468-1475 ◽  
Author(s):  
Yee Tak Derek Cheung ◽  
William Ho Cheung Li ◽  
Man Ping Wang ◽  
Tai Hing Lam
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Replacement Therapy ◽  
Controlled Trial ◽  
Adjusted Risk ◽  
Randomized Controlled ◽  
Adjusted Risk Ratio ◽  
Quit Attempts ◽  
Brief Advice

Abstract Introduction Outdoor smoking hotspots are convenient venues for promoting smoking cessation. This randomized controlled trial aimed to obtain proof-of-concept evidence of the feasibility and preliminary effectiveness on quit attempts of delivering a 1-week free nicotine replacement therapy sample (NRTS) to smokers. Methods This pilot parallel, single-blinded, two-group (1:1) randomized controlled trial proactively recruited adult smokers in outdoor smoking hotspots in Hong Kong. Smokers consuming at least 10 cigarettes per day and fit for NRT use were individually randomized to receive either a 1-week NRT gum/patch and brief advice lasting 10 minutes (NRTS, n = 50), or receive only brief advice (control, n = 50). The primary outcomes were any self-reported quit attempts (stop smoking for at least 24 hours) at 1- and 3-month telephone follow-up. Risk ratios from log-binomial regression models were used to assess the associations. Results The NRTS increased quit attempts at 1-month (14% vs. 10%; adjusted risk ratio = 1.25, 95% CI = 0.43 to 3.61) and 3-month follow-up (26% vs. 12%; adjusted risk ratio = 2.17, 95% CI = 0.89 to 5.27), but the differences were not significant. Trial participation rate was about 81.3%. Around 54% of the intervention group participants used the NRT sample by the first month. The NRT users reported generally positive feedback about the usefulness of NRT sample for smoking cessation. Major factors of not using NRT included bad gum taste and their perception that NRT was not useful. Conclusions Delivering NRTS to smokers in outdoor smoking hotspots was feasible and efficacious in increasing NRT use. Additional post-recruitment support to sustain the use of NRT and cessation services is needed. Implications Our study supported that smokers at outdoor smoking hotspots can be approached for a brief smoking cessation intervention including an onsite delivery of NRTS. Delivering NRTS and a brief advice on using NRT to these smokers was feasible and efficacious to increase NRT use. A larger trial on the benefits on quit attempts and long-term abstinence is warranted.

scholarly journals Knowledge of and practices related to smoking cessation among physicians in Nigeria

2009 ◽  
Vol 35 (12) ◽  
pp. 1198-1203 ◽  
Author(s):  
Olufemi Olumuyiwa Desalu ◽  
Adebowale Olayinka Adekoya ◽  
Adetokunbo Olujimi Elegbede ◽  
Adeolu Dosunmu ◽  
Tolutope Fasanmi Kolawole ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
School Curriculum ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Treatment Facilities ◽  
Tobacco Education ◽  
Brief Advice ◽  
Appropriate Practices ◽  
Structured Questionnaire

OBJECTIVE: To evaluate the knowledge and practices of smoking cessation among physicians in Nigeria. METHODS: We conducted a cross-sectional survey in Lagos and three geopolitical zones of Nigeria. A self-administered structured questionnaire was used to obtain information on tobacco use and its health effects, as well as on the knowledge and practices of smoking cessation, from 436 physicians. RESULTS: Of the 436 physicians, 292 (67.0%) were aware of smoking cessation, but only 132 (30.3%) showed good knowledge on this topic. The prevalence of smoking among the physicians was 17.7%. In addition, 308 physicians (70.6%) reported that tobacco education in the medical school curriculum was inadequate. Of the 436 physicians, 372 (86.2%) asked their patients whether they smoked, and 172 (39.4%) asked their patients the reasons for using tobacco. As a means of smoking cessation intervention, 268 (61.5%) used brief advice/counseling (2-5 min), 12 (3.7%) prescribed antidepressants, 16 (2.8%) prescribed nicotine replacement therapy (NRT), and 76 (17.4%) arranged follow-up visits. When the physicians were questioned regarding the obstacles to smoking cessation interventions, 289 (66.3%) cited poor knowledge of the issue, 55 (12.6%) cited a lack of time, and 20 (4.6%) cited unavailability of NRT. CONCLUSIONS: The results of this study highlight the lack of knowledge among physicians in Nigeria in terms of smoking cessation, as well as their failure to apply appropriate practices. The results of this study can further the evaluation and formulation of guidelines on smoking cessation and smoking education programs for physicians. Our findings also underscore the need to offer smoking cessation programs in all treatment facilities.

scholarly journals COach2Quit: A Pilot Randomized Controlled Trial of a Personal Carbon Monoxide Monitor for Smoking Cessation

2018 ◽  
Vol 21 (11) ◽  
pp. 1573-1577 ◽  
Author(s):  
Nandita Krishnan ◽  
Jessica L Elf ◽  
Sandy Chon ◽  
Jonathan E Golub
Keyword(s):  
Carbon Monoxide ◽  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Quit Smoking ◽  
Motivation To Quit ◽  
Brief Advice ◽  
Median Change

Abstract Introduction Mobile phone–based messaging support and biomarker feedback independently show evidence of increasing an individual’s likelihood of quitting smoking. However, the combination of these two strategies to facilitate smoking cessation has not been adequately explored. Methods We conducted a randomized controlled trial in Baltimore, Maryland, to assess the efficacy of COach2Quit, a smartphone application that provides exhaled carbon monoxide readings with message support. The primary outcome was self-reported and biochemically verified smoking cessation at 30-day follow-up. Secondary outcomes were reduction in smoking, motivation to quit, and engagement and satisfaction with COach2Quit. An intention-to-treat analysis was conducted. Results Adult smokers were randomized 1:1 to receive brief advice and COach2Quit (intervention, n = 50) or brief advice only (control, n = 52). Thirteen participants were lost to follow-up. At 30-day follow-up, one participant in each arm quit smoking. Median change in carbon monoxide levels (in parts per million (ppm)) (intervention: −3.0 [interquartile range (IQR) −12.0, 2.0]; control: −2.5 [IQR −9.0, 2.0]) and median change in number of cigarettes smoked per day (intervention: −5.5 [IQR −14.0, −1.0]; control: −6.0 [IQR −10.0, −2.0]) was similar between study arms. There was no significant difference in mean percent change in the Reasons for Quitting scale score (intervention: 6.3 [95% confidence interval = −2.2% to 14.8%]; control: −3.6 [95% confidence interval = −9.2% to 2.1%]). A majority (n = 32, 91%) of participants liked having COach2Quit to help them quit smoking. Conclusions There were no significant differences in smoking cessation, smoking reduction, and motivation to quit between study arms. However, high satisfaction with the COach2Quit application indicates its feasibility and acceptability as a smoking cessation tool. Implications Smoking is the leading preventable cause of morbidity and mortality in the United States. Although counseling and pharmacotherapy are efficacious for smoking cessation, they are not easily accessible or desirable to all smokers, highlighting the need for identifying other interventions. There is evidence for the efficacy of mobile phone–based messaging support for smoking cessation. However, there is limited research on the efficacy of biomarker feedback, much less interventions that combine these two approaches. This research contributes to filling this gap and identifying novel interventions to facilitate smoking cessation.

Awareness of Pregnant Women for COVID-19 Infection

2020 ◽  
Author(s):  
Erhan Okuyan ◽  
Emre Gunakan ◽  
Sertaç Esin
Keyword(s):  
Pregnant Women ◽  
Respiratory Diseases ◽  
Prospective Observational Study ◽  
Information Source ◽  
Home Birth ◽  
Patient Characteristics ◽  
Emotional Status ◽  
Prevention Method ◽  
And Behavior

Covid outbreak has been getting worse and spread affected all over the world. Pregnant patients are also vulnerable to respiratory diseases. We aimed to evaluate the awareness, emotional status, and behavior of pregnant during the COVID outbreak. This study's main benefit is to analyze the knowledge and understanding of pregnant women about the pandemic and draw attention to the prevention issues that need improvement. This research is a prospective observational study that 199 patients subjected to a questionnaire including 29 questions about patient characteristics, pregnancy information, knowledge about COVID19-infection, behavioral and emotional changes. 130 (65.3) of the patients stated an above-average knowledge level. Television was the most frequent information source (75.4%, n:150) and was the only information source for 90 (45.1%) of the patients. Sixty-nine patients used more than one information source. More than one prevention method uses by 149 (75%) of the patients. Washing hands (n:183, 92.0%) and cleaning the house (n:122, 61.3%) were the most preferred methods. Only 55 (27.6%) of the patients used a mask for prevention. 88(44.2%) of the patients stated that they preferred a shorter hospital stay, and 75 (37.7%) of the patients indicated that they postponed or avoided the pregnancy follow-up visits due to the COVID-19 issue. Pregnant women seem to be aware and stressed of COVID-19, but knowledge of what to do seems insufficient. Patients informed of risks of COVID infection, unplanned hospital admission, and chances of avoiding necessary visits and home birth demands.

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