June 28, 2010 - Smokers seek care from a variety of health professionals, not just primary care physicians.  Yet, despite these health professionals’ frequent contact with smokers who may need help with cessation, little is known about the providers’ smoking prevalence, cessation practices, and beliefs about smoking cessation.  A recent study published in Nicotine and Tobacco Research surveyed U.S. health professionals to determine their cessation efforts with patients, specifically whether or not they were performing the 5 A’s: Asking, Advising, Assessing, Assisting, and Arranging follow-up.  Researchers Tong et al. also studied factors that may be influencing these cessation practices.

This study looked at 2,804 health professionals who were primary care physicians, emergency medicine physicians, psychiatrists, registered nurses, dentists, dental hygienists, or pharmacists and asked them to self report their smoking status, their beliefs about tobacco cessation, their knowledge of cessation practices, and their adherence to following the 5 A’s.  Prevalence rates among health professionals were determined to be fairly low (less than 6%), except among nurses who had a smoking prevalence rate of 13%.

An assessment of the 5 A’s found that while the majority of health professionals reported asking (87.3%–99.5%) and advising about smoking (65.6%–94.9%), fewer reported assessing a smoker’s interest (38.7%–84.8%), assisting (16.4%–63.7%), or arranging for follow-up (1.3%–23.1%).  From self-reports it was determined that health professionals who reported using multiple components of the 5 A’s were generally aware of the Public Health Service guidelines, had training in cessation, and believed treatment to be an important part of their professional practice.  Those health professionals who did not self report using multiple components of the 5 A’s were more likely to be current smokers, to not believe in counseling, to feel uncomfortable asking patients about their smoking status, to have other priorities competing for their time, and to not be a primary care physician.

Study results have shown that many U.S. heath professionals are not adequately using the 5 A’s, which are known to be an important component of tobacco cessation interventions, and that health professionals who are not primary care physicians may not be involved in cessation efforts as much as they could be.  However, with knowledge gained from this study, more informed approaches to overcome the barriers influencing the performance of the 5 A’s can be developed and more heath professionals can become involved in tobacco cessation.

For more information please visit: http://ntr.oxfordjournals.org/cgi/content/abstract/ntq071?eaf