African American primary care physicians' perceptions and practices regarding smoking cessation therapy

Joyce E Balls, James H Price, Joseph A Dake, Timothy R Jordan, Sadik Khuder
Journal of the National Medical Association 2010, 102 (7): 579-89
African American smokers (34% of males and 23% of females) need formal interventions to assist them in quitting smoking, a major method of preventing premature mortality from smoking-related illnesses. The purpose of this study was to examine African American primary care physicians' perceptions and practices regarding smoking cessation counseling. A national random sample (n=202) of primary care physicians was asked about their perceptions and practices regarding smoking cessation therapy. Most (89%) placed themselves in the maintenance stage for asking their patients about their smoking status and regularly documented the smoking status of their patients (70%). Most physicians did not comply with all of the components of the U.S. Public Health Services' smoking cessation guidelines (e.g., 5 A's and 5 R's). The component most often implemented of the 5 A's was to "advise" patients to quit (89%), and "arrange" followup was the least frequently (60%) used component. Perceived barriers to engaging in smoking cessation interventions were time (38%) and patients not interested in quitting (19%). Although physicians used many of the steps in the 5 A's and 5 R's, they were far less compliant in recommending nicotine replacement therapy, prescribing pharmacotherapy, and providing support and/or follow-up for patients who were willing to quit smoking. Physicians need more academic preparation in providing smoking cessation counseling since few received such training in medical school (31%) or during their residency programs (18%).

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