Clinical Psychologists and Smoking Cessation: Treatment Practices and Perceptions

Abstract

A random sample of clinical psychologists was surveyed regarding their smoking cessation practices and perceptions. A total of 352 psychologists responded (57%) to the valid and reliable questionnaire. The majority (59.1%) of psychologists did not always identify and document the smoking status of patients. The majority reported high efficacy expectations (66.4%) and low outcome expectations (55.1%) for using the 5A's smoking cessation counseling technique. Counselors that had never smoked were almost two times more likely to have higher efficacy expectations than those that were current smokers or ex-smokers (OR = 1.94, 95% CI 1.18-3.12). The factors that predicted regular use of the 5A's included the number of identified barriers, psychologists' level of self efficacy, and the urbanicity of one's practice location.

Smoking and environmental characteristics of smokers with a mental illness, and associations with quitting behaviour and motivation; a cross sectional study

“…Physician advice has been identified to have a particularly positive impact on smoking and quitting behaviour [ 65 ] and this was reinforced by the study finding that those participants who perceived psychiatrists as supportive of quitting were more likely to have recently made a greater number of quit attempts. Although the differences in the perceived support across the health professional groups were minimal, ‘other’ mental health professionals were least likely to be seen as supportive; a finding somewhat reflective of previous research suggesting allied health professionals, including psychologists are less likely to routinely assess for or offer intervention for smoking [ 66 ], despite the likely efficacy of their doing so [ 33 ]. It is possible that higher rates of nicotine dependence reported among some mental health professions, compared to their general health counterparts contributes to a more benign perception of smoking [ 67 ] and hence a lower likelihood of intervening.…”

Dispositional Mindfulness and Personal Distress as Predictors of Counseling Self‐Efficacy

“…Known as counseling self‐efficacy (Larson et al, 1992), a counselor’s belief that he or she will be able to effectively perform counseling‐related tasks in the near future is considered to be “a primary mechanism between simply knowing how to help in a counseling situation and actually executing effective counseling actions” (Greason & Cashwell, 2009, p. 3). Mental health professionals are more likely to use specific strategies with clients if they believe they can effectively implement those strategies (Akpanudo, Price, Jordan, Khuder, & Price, 2009). Therefore, by cultivating counseling self‐efficacy during counselor training, counselor educators help student counselors develop confidence and overcome the anxiety that can be associated with learning a new skill.…”

Psychologists and Smoking Cessation Intervention: Unrealised Potential

“…Behavioural health providers such as psychologists seem especially well-suited to provide smoking cessation intervention for a multitude of reasons (Akpanudo et al, 2009;Wetter et al, 1998;Williams & Ziedonis, 2004). Nicotine dependence is recognised as a substance use disorder by the Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV; American Psychiatric Association, 1994), and is often co-morbid with other psychological disorders with which patients are likely to present to psychologists (Access Economics, 2007;Australian Bureau of Statistics, 2010;Morissette et al, 2007).…”

“…Despite the potential of psychologists, and the existence of comprehensive evidence-based guidelines for providing smoking cessation intervention that might be adopted in psychological practice (Fiore et al, 2008;Zwar et al, 2005), research suggests that psychologists do not routinely assess the smoking status of their clients (Akpanudo et al, 2009;Leffingwell & Babitzke, 2006;Phillips & Brandon, 2004) let alone offer opportunistic smoking cessation intervention (Akpanudo et al, 2009;Hjalmarson & Saljoojee, 2005;Phillips & Brandon, 2004). Two studies undertaken in the US, suggest that intervention for smoking seems less likely to occur than intervention for the use of other substances such as alcohol and illicit drug abuse (Phillips & Brandon, 2004) and other health risk behaviours, such as unsafe sex, reckless driving, gambling and lack of physical activity (Phillips & Brandon, 2004;Wendt, 2005).…”

“…Potential barriers to the provision of smoking cessation intervention by psychologists have been reported to include: lack of training, lack of time, perceived costs of cessation intervention for the therapeutic relationship, perception that smoking cessation intervention is not a psychologists' responsibility or role, and beliefs that clients are uninterested or will be unreceptive to intervention (Akpanudo et al, 2009;Fiore et al, 2008;Leffingwell & Babitzke, 2006;Phillips & Brandon, 2004;Wetter et al, 1998).…”