Profile of tobacco users identified in primary care practice and predictors of readiness to quit: a cross-sectional survey

Abstract

Background:The aim of this study was to document the prevalence of tobacco use and describe the characteristics of tobacco users identified in primary care practices. Methods:We conducted a cross-sectional survey in 49 primary care practices in the province of Ontario. Consecutive patients were screened for smoking status at the time of their clinic appointment. Patients reporting current tobacco use completed a survey, which documented sociodemographic and smoking-related characteristics. Multilevel modelling was used to examine predictors of readiness to quit smoking and the presence of anxiety and/or depression.Results: A total of 56 592 patients were screened, and 5245 tobacco users participated in the survey. Prevalence of tobacco use was 18.2% and varied significantly across practices (range 12.4%-36.1%). Of the respondents, 46.3% reported current anxiety and/or depression, and 61.3% reported smoking within the first 30 minutes of waking. A total of 41.1% of respondents reported they were ready to quit smoking in the next 6 months, and 30.1% reported readiness to quit in the next 30 days. Readiness to quit was positively associated with higher self-efficacy, male sex, presence of chronic obstructive pulmonary disease and more years of tobacco use. The presence of anxiety and/or depression was associated with lower cessation self-efficacy and time to first cigarette within 30 minutes of waking, but did not predict readiness to quit.Interpretation: Tobacco users identified in primary care practices reported high rates of nicotine dependence and anxiety and/or depression, but also high rates of readiness to quit. Study findings support the need to tailor interventions to address the needs of tobacco users identified in primary care settings. Abstract Research CMAJ OPEN E42CMAJ OPEN, 4(1) Methods Design and settingData collection activities occurred in a sample of 49 primary care practices in the province of Ontario. An invitation to participate in the study was sent to all family health teams (n = 90) from 6 health regions in Ontario (Champlain Local Health Integration Network [LHIN], South East LHIN, Central East LHIN, Waterloo Wellington LHIN, Mississauga Halton LHIN and Erie St. Clair LHIN). A telephone call was also placed by a member of the project team to confirm receipt and answer any questions about study participation. From each participating primary care practice, a crosssectional sample of patients who used tobacco completed the study survey. Sources of dataIn each primary care practice, consecutive patients scheduled for an annual examination or nonurgent appointment were screened for eligibility upon check-in to the clinic. A research assistant was located in primary care practice waiting rooms and was responsible for screening all patients for eligibility and for all data collection activities. Patients were eligible to participate if they met the following criteria: (1) a current smoker (≥ 1 cigarette per day in past 7 days); (2) 18 years of age or older; (3) had a scheduled appointment with a ...

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