Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-13T12:01:35.572Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors Influencing Smoking Cessation Counselling: A Qualitative Study of Medical Residents

Published online by Cambridge University Press:  13 December 2013

Stasi Lubansky ,
Corrine Y. Jurgens  and
Carla Boutin-Foster
Stasi Lubansky*
Affiliation:
Weill Cornell Internal Medicine Associates
Corrine Y. Jurgens
Affiliation:
Clinical Associate Professor at Stony Brook University School of Nursing
Carla Boutin-Foster
Affiliation:
Weill Cornell Medical College
*
Address for Correspondence: Stasi Lubansky DNP, ANP, CTTS, Staff Associate, Adult Nurse Practitioner and Certified Tobacco Treatment Specialist, Weill Cornell Internal Medicine Associates, New Yorkslubansk@med.cornell.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: Physicians in training must be able to counsel their patients on smoking cessation, however, little is known about the barriers that they face to counselling their patients.

Aims: The study sought to identify barriers to smoking cessation counselling specific to physicians in training.

Methods: Qualitative interviews in the form of focus groups were conducted with 30 medical residents. Focus groups were audio taped, transcribed verbatim and coded by two independent reviewers. Similar codes were grouped to form categories and then aggregated to form themes.

Results: Seven themes emerged describing resident barriers to provision of smoking cessation counselling : (1) Lack of self-efficacy for providing counselling; (2) their perception that patients are not willing to change; (3) a lack of available resources/information for providers and patients; (4) differences in supervising physician's recommendations; (5) perceived lack of time; (6) a perception of lack of continuous care; and (7) a lack of practical skills in counselling.

Conclusions: This study highlighted residents’ perceived barriers to providing smoking cessation counselling. These barriers are similar to those encountered by other providers. Additional barriers specific to residency exist and more training is necessary.

Practice Implications: The barriers that physicians encounter to smoking cessation counselling must be addressed early on in residency training.

Type
Articles
Information
Journal of Smoking Cessation , Volume 10 , Issue 1 , June 2015 , pp. 29 - 34
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Babor, T. F., McRee, B. G., Kassebaum, P. A., Grimaldi, P. L., Ahmed, K., & Bray, J. (2007). Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. Substance Abuse, 28 (3), 7–30.CrossRefGoogle Scholar
Blumenthal, D. S. (2007). Barriers to the provision of smoking cessation services reported by clinicians in underserved communities. Journal of American Board of Family Medicine, 20 (3), 272–279.Google Scholar
Cornuz, J., Humair, J. P., Seematter, L., Stoianov, R., van Melle, G., Stalder, H., et al. (2002). Efficacy of resident training in smoking cessation: a randomized, controlled trial of a program based on application of behavioral theory and practice with standardized patients. Annals of International Medicine, 136 (6), 429–437.Google Scholar
Cornuz, J., Zellweger, J. P., Mounoud, C., Decrey, H., Pecoud, A., & Burnand, B. (1997). Smoking cessation counseling by residents in an outpatient clinic. Preventative Medicine, 26 (3), 292–296.CrossRefGoogle Scholar
Cummings, S. R., Stein, M. J., Hansen, B., Richard, R. J., Gerbert, B., & Coates, T. J. (1989). Smoking counseling and preventive medicine. A survey of internists in private practices and a health maintenance organization. Archives of International Medicine, 149 (2), 345–349.Google Scholar
Duffy, F. D., Gordon, G. H., Whelan, G., Cole-Kelly, K., Frankel, R., Buffone, N., et al. (2004). Assessing competence in communication and interpersonal skills: the Kalamazoo II report. Academy of Medicine, 79 (6), 495–507.CrossRefGoogle ScholarPubMed
Fiore, J. C., Baker, T. B., et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Rockville, MD: US Department of Health and Human Services. Public Health Service.Google Scholar
Green, J., Willis, K., Hughes, E., Small, R., Welch, N., Gibbs, L., et al. (2007). Generating best evidence from qualitative research: the role of data analysis. Australian and New Zealand Journal of Public Health, 31 (6), 545–550.Google Scholar
Hymowitz, N., Schwab, J., Keith Haddock, C., Pyle, S., & Meshberg, S. (2005). The pediatric residency training on tobacco project: baseline findings from the patient tobacco survey. Preventative Medicine, 41 (1), 159–166.Google Scholar
Madras, B. K., Compton, W. M., Avula, D., Stegbauer, T., Stein, J. B., & Clark, H. W. (2009). Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and 6 months later. [doi: 10.1016/j.drugalcdep.2008.08.003]. Drug and Alcohol Dependence, 99 (1–3), 280–295.Google Scholar
Milch, C. E., Edmunson, J. M., Beshansky, J. R., Griffith, J. L., & Selker, H. P. (2004). Smoking cessation in primary care: a clinical effectiveness trial of two simple interventions. Preventative Medicine, 38 (3), 284–294.CrossRefGoogle ScholarPubMed
Montner, P., Bennett, G., & Brown, C. (1994). An evaluation of a smoking cessation training program for medical residents in an inner-city hospital. Journal National Medicine Association, 86 (9), 671–675.Google Scholar
Morgan, D. L. (1997). Focus Groups as Qualitative Research / David L. Morgan (2nd ed.). Thousand Oaks, Calif.: Sage Publications.Google Scholar
Pederson, L. L., Blumenthal, D. S., Dever, A., & McGrady, G. (2006). A web-based smoking cessation and prevention curriculum for medical students: why, how, what, and what next. Drug Alcohol Review, 25 (1), 39–47.CrossRefGoogle ScholarPubMed
Powers, C. A., Zapka, J., Biello, K. B., O'Donnell, J., Prout, M., & Geller, A. (2010). Cultural competency and tobacco control training in US medical schools: many but missed opportunities. Journal of Cancer Education, 25 (3), 290–296.Google Scholar
Roman, B., Borges, N., & Morrison, A. K. (2011). Teaching motivational interviewing skills to third-year psychiatry clerkship students. Academy of Psychiatry, 35 (1), 51–53.Google Scholar
Scal, P., Hennrikus, D., Ehrlich, L., Ireland, M., & Borowsky, I. (2004). Preparing residents to counsel about smoking. Clinical Pediatrics (Philanthropy), 43 (8), 703–708.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 Preventative Medicine, 31 (3), 233–239.CrossRefGoogle ScholarPubMed
Strecher, V. J., O'Malley, M. S., Villagra, V. G., Campbell, E. E., Gonzalez, J. J., Irons, T. G., et al. (1991). Can residents be trained to counsel patients about quitting smoking? Results from a randomized trial. Journal of General International Medicine, 6 (1), 9–17.Google Scholar
Tetrault, J. M., Green, M. L., Martino, S., Thung, S. F., Degutis, L. C., Ryan, S. A., et al. (2011). Developing and implementing a multispecialty graduate medical education curriculum on Screening, Brief Intervention, and Referral to Treatment (SBIRT). [doi: 10.1080/08897077.2011.640220]. Substance Abuse, 33 (2), 168–181.Google Scholar
Thorndike, A. N., Regan, S., & Rigotti, N. A. (2007). The treatment of smoking by US physicians during ambulatory visits: 1994–2003. American Journal of Public Health, 97 (10), 1878–1883.CrossRefGoogle Scholar
USPSTF (2009). Counseling to prevent tobacco use and tobacco-caused disease Vital signs: current cigarette smoking among adults aged >/ = 18 years–United States, 2005–2010. (2011). MMWR Morbidity and Mortality Weekly Report, 60 (35), 1207–1212./+=+18+years–United+States,+2005–2010.+(2011).+MMWR+Morbidity+and+Mortality+Weekly+Report,+60(35),+1207–1212.>Google Scholar
von Garnier, C., Meyer, M., Leuppi, J., Battegay, E., & Zeller, A. (2010). Smoking cessation counselling: impact of chart stickers and resident training. Swiss Medicine Weekly, 140 (11–12), 175–180.Google ScholarPubMed
Zallman, L., Ma, J., Xiao, L., & Lasser, K. E. (2010). Quality of US primary care delivered by resident and staff physicians. Journal of General International Medicine, 25 (11), 1193–1197.Google Scholar