Physicians

Physicians are in a special position to motivate their clients to change and thus significantly reduce smoking among their clients.

Physicians could help a large number of clients quit smoking by:¹

• Taking time to advise them about quitting
• Helping them plan a date to quit
• Giving them self-help materials
• Following up with motivation and progress toward smoking cessation
• Referring some to smoking cessation programs

Cigarette smoking is the leading avoidable cause of mortality in the U.S., accounting for 400,000 deaths each year. Physicians can play a major role in a client's life regarding smoking cessation.

Clients who smoke are not only at risk for lung cancer and heart disease, but smoking has been related to the premature development of microvascular complications of diabetes and may even have a role in the development of Type II diabetes.²

However, a study that appeared in a 1999 issue of the Journal of the National Cancer Institute, found that very few physicians counsel their young clients about the health risks of smoking despite the fact that most smokers take up the habit as adolescents. In fact, a report from physicians in the General Medicine Division of the Massachusetts General Hospital (MGH) found that, even when they knew their clients were smokers, physicians reported discussing smoking at office visits less than 20% of the time.

It is important for physicians to gather information regarding effective smoking interventions (e.g., nicotine replacement therapies, medications, etc.), and to disseminate some of this information to their clients.

Helpful Links

The American Medical Association A private sector panel of experts developed a How-To Guide for Clinicians which provides information on first-line pharmacologic therapies and counseling to help clients quit using tobacco.

The American Academy of Family Physicians (AAFP) "Ask and Act Practice Toolkit" includes a number of tobacco cessation resources that can be utilized to help your patients quit.

The National Cancer Institute offers an entire monograph regarding information on smoking interventions for medical and dental practices (http://cancercontrol.cancer.gov/tcrb/monographs/5/index.html).

The American College of Chest Physicians provides an online course for physicians covering the impact of tobacco dependence, treatment, relapse prevention, and special populations of tobacco users.

CLICK HERE to find out more about the link between Smoking and Mesothelioma from the the Asbestos and Mesothelioma Center.

Drs. Fiore and Baker (2011) present a review of formal guidelines and clinical recommendations for treating smokers in the health care setting. CLICK HERE to view the article, published in The New England Journal of Medicine.

Fax to Assist

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¹ Cummings, S.R., et al. (1989). Smoking counseling and preventive medicine. A survey of internists in private practices and a health maintenance organization. Archives of Internal Medicine, 149, 345-9.

² Haire-Joshu, D., Glasgow, R.E., & Tibbs, T.L. (1999). Smoking and diabetes. Diabetes Care, 22, 1887-98.