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Use of Smoking Cessation Interventions by Physicians in Argentina

Published online by Cambridge University Press:  21 November 2014

Veronica Schoj ,
Raul Mejia ,
Mariela Alderete ,
Celia P. Kaplan ,
Lorena Peña ,
Steven E. Gregorich ,
Ethel Alderete  and
Eliseo J. Pérez-Stable
Veronica Schoj
Affiliation:
Fundacion Interamericana del Corazon Argentina, Buenos Aires, Argentina
Raul Mejia
Affiliation:
Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
Mariela Alderete
Affiliation:
Fundacion Interamericana del Corazon Argentina, Buenos Aires, Argentina
Celia P. Kaplan
Affiliation:
Department of Medicine, Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco
Lorena Peña
Affiliation:
Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
Steven E. Gregorich
Affiliation:
Department of Medicine, Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco
Ethel Alderete
Affiliation:
Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); Universidad Nacional de Jujuy, Argentina
Eliseo J. Pérez-Stable*
Affiliation:
Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina Department of Medicine, Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco
*
Address for correspondence: Eliseo J. Pérez-Stable, MD, Department of Medicine, Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, 3333 California Street, San Francisco, CA 94143-0856. Email: [email protected]
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Abstract

Background: Physician-implemented interventions for smoking cessation are effective but infrequently used. We evaluated smoking cessation practices among physicians in Argentina.

Methods: A self-administered survey of physicians from six clinical systems asked about smoking cessation counselling practices, barriers to tobacco use counselling and perceived quality of training received in smoking cessation practices.

Results: Of 254 physicians, 52.3% were women, 11.8% were current smokers and 52% never smoked. Perceived quality of training in tobacco cessation counselling was rated as very good or good by 41.8% and as poor/very poor by 58.2%. Most physicians (90%) reported asking and recording smoking status, 89% advised patients to quit smoking but only 37% asked them to set a quit date and 44% prescribed medications. Multivariate analyses showed that Physicians' perceived quality of their training in smoking cessation methods was associated with greater use of evidence-based cessation interventions. (OR = 6.5; 95% CI = 2.2–19.1); motivating patients to quit (OR: 7.9 CI 3.44–18.5), assisting patients to quit (OR = 9.9; 95% CI = 4.0–24.2) prescribing medications (OR = 9.6; 95% CI = 3.5–26.7), and setting up follow-up (OR = 13.0; 95% CI = 4.4–38.5).

Conclusions: Perceived quality of training in smoking cessation was associated with using evidence-based interventions and among physicians from Argentina. Medical training programs should enhance the quality of this curriculum.

Type
Original Articles
Information
Journal of Smoking Cessation , Volume 11 , Issue 3 , September 2016 , pp. 188 - 197
Copyright
Copyright © The Author(s) 2014 

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References

Alba, L. H., Murillo, R., & Castillo, J. S. (2013). Counseling interventions for smoking cessation: Systematic review. Salud Publica Mex, 55 (2), 196–206. Doi: S0036-36342013000200012 [pii].Google Scholar
Blumenthal, D. S. (2007). Barriers to the provision of smoking cessation services reported by clinicians in underserved communities. The Journal of the American Board of Family Medicine, 20 (3), 272–279. Doi: 10.3122/jabfm.2007.03.060115.Google Scholar
Cahill, K., Lancaster, T., & Green, N. (2010). Stage-based interventions for smoking cessation. Cochrane Database of Systematic Reviews, (11), CD004492. Doi: 10.1002/14651858.CD004492.pub4.Google Scholar
Cahill, K., Stead, L. F., & Lancaster, T. (2012). Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews, 4, CD006103. Doi: 10.1002/14651858.CD006103.pub6.Google Scholar
Fiore, M. C., Jaén, C. R., Baker, T. B., Bailey, W. C., Benowitz, N. L., Curry, S. J. et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD.Google Scholar
Frank, E., & Harvey, L. K. (1996). Prevention advice rates of women and men physicians. Archives of Family Medicine, 5 (4), 215–219.Google Scholar
Gigliotti, E., Ferrero, F., Castanos, C., Blengini, M. T., Duran, P., & Moreno, L. (2013). Tobacco consumption among pediatric residents in Argentina: Current prevalence and trend over the past 10 years. Archivos Argentinos de Pediatría, 111 (4), 315–321. Doi: S0325-00752013000400010 [pii] 10.1590/S0325-00752013000400010.Google Scholar
Huang, C., Guo, C., Yu, S., Feng, Y., Song, J., Eriksen, M. et al. (2013). Smoking behaviours and cessation services among male physicians in China: Evidence from a structural equation model. Tobacco Control. doi: 10.1136/tobaccocontrol-2012-050884. [Epub 2013 Jul 2].Google Scholar
Hughes, J. R., Stead, L. F., Hartmann-Boyce, J., Cahill, K., & Lancaster, T. (2014). Antidepressants for smoking cessation. Cochrane Database of Systematic Reviews, (1), CD000031. Doi: 10.1002/14651858.CD000031.pub3.Google Scholar
Juliao, A. M., Camargo, A. L., Citero Vde, A., Maranhao, M. F., Maluf Neto, A., Paes, A. T. et al. (2013). Physicians’ attitude towards tobacco dependence in a private hospital in the city of Sao Paulo, Brazil. Einstein (Sao Paulo), 11 (2), 158–162. Doi: S1679-45082013000200004 [pii].Google Scholar
Kaplan, C. P., Perez-Stable, E. J., Fuentes-Afflick, E., Gildengorin, V., Millstein, S., & Juarez-Reyes, M. (2004). Smoking cessation counseling with young patients: The practices of family physicians and pediatricians. Archives of Pediatrics & Adolescent Medicine, 158 (1), 83–90. Doi: 10.1001/archpedi.158.1.83 158/1/83 [pii].Google Scholar
Kruger, J., Shaw, L., Kahende, J., & Frank, E. (2012). Peer reviewed: Health care providers’ advice to quit smoking, national health interview survey, 2000, 2005, and 2010. Preventing Chronic Disease, 9, 110340. Doi: http://dx.doi.org/10.5888/pcd9.110340.Google Scholar
Lai, D. T., Cahill, K., Qin, Y., & Tang, J. L. (2010). Motivational interviewing for smoking cessation. Cochrane Database of Systematic Reviews, (1), CD006936. Doi: 10.1002/14651858.CD006936.pub2.Google Scholar
Lancaster, T., & Stead, L. (2004). Physician advice for smoking cessation. [Meta-Analysis Review]. The Cochrane Database of Systematic Reviews, (4), CD000165. Doi: 10.1002/14651858.CD000165.pub2.Google Scholar
Lee, D. J., Fleming, L. E., McCollister, K. E., Caban, A. J., Arheart, K. L., LeBlanc, W. G. et al. (2007). Healthcare provider smoking cessation advice among US worker groups. (Research Support, Non-U.S. Gov't Research Support, U.S. Gov’t, P.H.S.) Tobacco Control, 16 (5), 325–328. Doi: 10.1136/tc.2006.019117.Google Scholar
Lemmens, V., Oenema, A., Knut, I. K., & Brug, J. (2008). Effectiveness of smoking cessation interventions among adults: A systematic review of reviews. European Journal of Cancer Prevention, 17 (6), 535–544. Doi:10.1097/CEJ.0b013e3282f75e48 00008469-200811000-00006 [pii].Google Scholar
Ley 26.687, Regulación de la publicidad, promoción y consumo de los productos elaborados con tabaco (2011). Argentina.Google Scholar
Mejia, R., Martinez, V. G., Gregorich, S. E., & Perez-Stable, E. J. (2010). Physician counseling of pregnant women about active and secondhand smoking in Argentina. (Research Support, N.I.H., Extramural) Acta Obstetricia et Gynecologica Scandinavica, 89 (4), 490–495. Doi: 10.3109/00016341003739567.Google Scholar
Minervini, M., Zabert, G., Rondelli, M., Gómez, M., Castaños, C., Buist, S. et al. (2006). Tobacco use among Argentine physicians: Personal behavior and attitudes. Revista Argentina de Medicina Respiratoria, 3, 100–105.Google Scholar
Ministerio de Salud de la Nacion (2005). Guia Nacional de Tratamiento de la Adiccion al Tabaco. Buenos Aires, Argentina. Available at: http://www.msal.gov.ar/tabaco/images/stories/info-equipos-de-salud/pdf/guia-practicatratamiento-adiccion-tabaco-2005.pdf.Google Scholar
Ministerio de Salud de la Nacion (2012). Gats/Encuesta Mundial de Tabaquismo en Adultos. Buenos Aires, Argentina. Available at: http://www.msal.gov.ar/ent/images/stories/vigilancia/pdf/GATS_FactSheetARG_FINAL.pdf.Google Scholar
Ng, N., Prabandari, Y. S., Padmawati, R. S., Okah, F., Haddock, C. K., Nichter, M. et al. (2007). Physician assessment of patient smoking in Indonesia: A public health priority. Tobacco Control, 16 (3), 190–196.Google Scholar
Noble, M., Perez Stable, E., & Casal, E. R. (1996). El comportamiento médico en relación al tabaquismo; Physician's behaviour relative to smoking. Boletín de la Academia Nacional de Medicina de Buenos Aires, 74 (2), 413–425.Google Scholar
Perez-Stable, E. J., Juarez-Reyes, M., Kaplan, C., Fuentes-Afflick, E., Gildengorin, V., & Millstein, S. (2001). Counseling smoking parents of young children: Comparison of pediatricians and family physicians. Archives of Pediatrics & Adolescent Medicine, 155 (1), 25–31. Doi: poa00148 [pii].Google Scholar
Pichon-Riviere, A., Alcaraz, A., Bardach, A., Augustovski, F., Caporale, J., & Francisco, C. (Mayo 2013). Carga de Enfermedad atribuible al Tabaquismo en Argentina. Documento Técnico IECS N° 7. Buenos Aires, Argentina: Instituto de Efectividad Clínica y Sanitaria.Google Scholar
Pipe, A., Sorensen, M., & Reid, R. (2009). Physician smoking status, attitudes toward smoking, and cessation advice to patients: An international survey. Patient Education and Counseling, 74 (1), 118–123.Google Scholar
Sadowski, I. J., Ruffieux, C., & Cornuz, J. (2009). Self-reported smoking cessation activities among Swiss primary care physicians. BMC Family Practice, 10 (1), 22.Google Scholar
Schnoll, R. A., Rukstalis, M., Wileyto, E. P., & Shields, A. E. (2006). Smoking cessation treatment by primary care physicians: An update and call for training. American Journal of Preventive Medicine, 31 (3), 233–239. Doi: S0749-3797(06)00174-7 [pii] 10.1016/j.amepre.2006.05.001.Google Scholar
Secretarıa de Programacion para la Prevencion de la Drogadiccion y la Lucha contra el Narcotrafico (2004). InformePreliminar: Segundo estudio nacional sobre consumo desustancias psicoactivas, poblacion de 12 a 65 años, Argentina. Buenos Aires: Ministerio de Salud.Google Scholar
Soto Mas, F. G., Balcazar, H. G., Valderrama Alberola, J., & Hsu, C. E. (2008). Correlates of tobacco cessation counseling among Hispanic physicians in the US: A cross-sectional survey study. BMC Public Health, 8, 5. Doi: 10.1186/1471-2458-8-5 1471-2458-8-5 [pii].Google Scholar
Soto Mas, F. G., Papenfuss, R. L., Jacobson, H. E., Hsu, C. E., Urrutia-Rojas, X., & Kane, W. M. (2005). Hispanic physicians’ tobacco intervention practices: A cross-sectional survey study. BMC Public Health, 5, 120. Doi: 1471-2458-5-120 [pii] 10.1186/1471-2458-5-120.Google Scholar
Stead, L. F., Buitrago, D., Preciado, N., Sanchez, G., Hartmann-Boyce, J., & Lancaster, T. (2013). Physician advice for smoking cessation. (Research Support, Non-U.S. Gov’t) The Cochrane Database of Systematic Reviews, 5, CD000165. Doi: 10.1002/14651858.CD000165.pub4.Google Scholar
Stead, L. F., & Lancaster, T. (2005). Group behaviour therapy programmes for smoking cessation. Cochrane Database of Systematic Reviews, (2), CD001007. Doi: 10.1002/14651858.CD001007.pub2.Google Scholar
Stead, L. F., Perera, R., & Lancaster, T. (2006). Telephone counselling for smoking cessation. Cochrane Database of Systematic Reviews, (3), CD002850. Doi: 10.1002/14651858.CD002850.pub2.Google Scholar
Tambussi, A., Schoj, V., Perel, P., Zabert, G., & Ortiz, Z. (2003). Revisión sistemática de estudios de prevalencia de tabaquismo en la Argentina. Programa Vigi+ A, Ministerio de Salud y Ambiente de la Nación.Google Scholar
Twardella, D., & Brenner, H. (2005). Lack of training as a central barrier to the promotion of smoking cessation: A survey among general practitioners in Germany. European Journal of Public Health, 15 (2), 140–145. Doi: cki123 [pii] 10.1093/eurpub/cki123.Google Scholar
Ulbricht, S., Baumeister, S. E., Meyer, C., Schmidt, C. O., Schumann, A., Rumpf, H. J. et al. (2009). Does the smoking status of general practitioners affect the efficacy of smoking cessation counselling? (Comparative Study Controlled Clinical Trial Research Support, Non-U.S. Gov’t) Patient education and counseling, 74 (1), 23–28. Doi: 10.1016/j.pec.2008.07.047.Google Scholar
Vogt, F., Hall, S., & Marteau, T. M. (2005). General practitioners’ and family physicians’ negative beliefs and attitudes towards discussing smoking cessation with patients: A systematic review. Addiction, 100 (10), 1423–1431. Doi: ADD1221 [pii] 10.1111/j.1360-0443.2005.01221.x.Google Scholar
Warren, C. W., Jones, N. R., & Chauvin, J. (2008). Tobacco use and cessation counselling: Cross-country. Data from the global health professions student survey (GHPSS), 2005–7. Tobacco Control, 17 (4), 238–247.Google Scholar
World Health Organization (2013). Global Health Professions Student Survey Retrieved November 6, 2013. Available at: http://www.emro.who.int/tobacco/gtss-matrix/.Google Scholar
Zabert, G., Chatkin, J. M., & Ponciano-Rodriguez, G. (2010). Reflections on smoking intervention opportunities in Latin America. Salud Publica de Mexico, 52, Suppl 2, S283–287. Doi: S0036-36342010000800025 [pii].Google Scholar
Zabert, G., & Verra, F. on behalf of Grupo Fumar (2004). Estudio F.U.M.Ar (Fumar en universitarios de medicina de Argentina): Informe final. Archivos de Bronconeumologia, 40 (s4), 28. (see http://apps.elsevier.es/watermark/ctl_servlet).Google Scholar
Zabert, G., Videla, A., & Verra, F., for the FUMAHBA Investigators (2005). Estudio FUMAHBA: (Fumar en Médicos Asistenciales en Hospitales de Buenos Aires). XXXIII Congreso Argentino de Medicina Respiratoria. Revista Argentina de Medicina Respiratoria, 5 (S1), 78. (see http://www.congresosaamr.org.ar/Congresos%202005.pdf).Google Scholar
Zhou, J., Abdullah, A. S., Pun, V. C., Huang, D., Lu, S., & Luo, S. (2010). Smoking status and cessation counseling practices among physicians, Guangxi, China, 2007. Preventing Chronic Disease, 7 (1), A15 [pii].Google Scholar
Zylbersztejn, H. M., Cardone, A., Vainstein, N., Mulassi, A., Calderón, J. G., Blanco, P. et al. (2007). Tabaquismo en médicos de la República Argentina: Estudio TAMARA. Revista Argentina de Cardiología, 75 (2), 109–116.Google Scholar
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