The views and attitudes of general practitioners and smokers toward provision of smoking cessation advice: a qualitative study

Cleland, Jennifer; Thomas, Michael; Pinnock, Hilary

doi:10.1016/j.pcrj.2004.05.003

Cited by 11 publications

(10 citation statements)

References 16 publications

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“…Given that patients prefer smoking cessation advice that is linked to health benefits (e.g. Cleland et al, 2004), these knowledge deficits may hinder provision of useful cessation advice.…”

Section: Discussionmentioning

confidence: 99%

Teaching smoking cessation knowledge to second-year undergraduates

et al. 2005

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Positive smoking cessation knowledge changes can be achieved through teaching. It is not known if, or how, increases in knowledge will contribute to actual interventions in practice. It is suggested that interventions to support medical undergraduates to develop the knowledge and skills required to support patients effectively in stopping smoking need to be part of an integrated programme of teaching clinical knowledge, communication and clinical skills, coupled with opportunities to practise in simulated situations.

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“…Given that patients prefer smoking cessation advice that is linked to health benefits (e.g. Cleland et al, 2004), these knowledge deficits may hinder provision of useful cessation advice.…”

Section: Discussionmentioning

confidence: 99%

Teaching smoking cessation knowledge to second-year undergraduates

et al. 2005

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“…In addition to not believing that the patient is motivated enough to quit smoking, many GPs report concern about harming the doctor-patient relationship by broaching the topic of smoking cessation with a potentially unreceptive patient, deciding, on balance, that protecting this relationship is more important than providing a smoking cessation intervention with questionable odds of succeeding. [262][263][264][265][266][267] Pilnick and Coleman 267 argue that smoking cessation is complex and that offering help on how to quit is difficult. They also suggest that the benefits of nicotine replacement therapy may be due not simply to the clinical effects but also to the legitimisation of the view that stopping smoking is an appropriate problem for medical intervention.…”

Section: Health Improvement Activities Undertaken In General Practicementioning

confidence: 99%

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Peckham

Falconer

Gillam

et al. 2015

Health Serv Deliv Res

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BackgroundThis project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities.AimsThe aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice.MethodsWe undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff.FindingsMany of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely.Future ResearchFuture research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…However, an alternative explanation is that smokers may be more reluctant to go to their general practice for preventive health care interventions, such as follow-up cytology, in case the visit prompts (unwanted) discussion of their smoking habits. Evidence suggests that smokers anticipate that they will be provided with antismoking advice when attending for health care 29,30 but that providing unsought advice can damage patient-GP trust, provoke negative reactions and have an impact on helpseeking behaviour. 29,31 Supporting this explanation, we note that the observed relationship with smoking was entirely limited to current smokers: ex-smokers had the same default risk as never-smokers.…”

Section: Socio-demographic and Lifestyle Risk Factors For Defaultmentioning

confidence: 99%