Physicians' Perceived Barriers to Promoting Smoking Cessation

Abstract

Background/Aims: Physicians' reluctance to promoting smoking cessation reduces the effectiveness of evidence-based recommendations resulting in suboptimal patient outcomes. Primary aim: to draw together findings from studies that addressed physicians' perceived barriers to promoting smoking cessation. Secondary aim: to assess whether interventions for reducing such perceived barriers impact on smoking cessation rates. Methods: Literature search in peer-reviewed journals focused on physicians' perceived barriers to addressing smoking cessation or on intervention studies aimed at alleviating these barriers. Results: The most frequently reported perceived barriers were: time constraints, high workload, lack of training, lack of reimbursement of smoking cessation interventions and the physician's own smoking status. Low outcome expectancy, lack of self-efficacy, fear of losing patients, being uncomfortable to discuss smoking hazards, dissatisfaction with professional activity were also reported. Smoking quit rates of intervention studies aimed to reduce perceived barriers varied according to the barrier targeted. Conclusion: Primary care physicians report a great number of perceived barriers to addressing smoking cessation. Results of intervention studies designed to reduce specific barriers with the purpose of increasing quit rates, remain conflicting. Multilevel intervention studies seem to be needed to assess the efficacy of alleviating perceived barriers to addressing smoking cessation.