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As stated before, the success rate of attempts to stop smoking var- ies between 4% and 20%, and it
takes most smokers several attempts before they completely stop smoking. After all, every person
who wants to stop smoking has a right to the most appropriate, customized treatment for his or her
addiction. 5. CONCLUSIONS Overall, healthcare professiona ls need to be convinced that tobacco
smoking is an addiction and should be treat- ed likewise. Each member of the core team was given a
list with all of the recommendations for follow-up research ap- pearing in the review. Also, future
studies could include patient-reported or more objective data, in order to gain further insights into
the implementation of smoking cessation counseling in practice. The patient exit interview as an
assessment of physician-delivered smoking intervention: a validation study. Why is it important to
evaluate the smoking cessation policy and its results ? Q 19. A preliminary search of Medline via
OVID served to identify relevant keywords. Tobacco use assessment and counselling practices
among Alabama primary care physicians. To browse Academia.edu and the wider internet faster and
more securely, please take a few seconds to upgrade your browser. Many cardiologists and
pulmonary physicians feel it is impor- tant to recommend stopping smoking, but consider pro- viding
support for attempts to do so more of a task for the general practitioner. A protocol for this literature
review was not registered. Table 2 shows the results of the Delphi procedure. 3.7. Recommendations
for Healthcare Practice - Expert Assessment The literature study also revealed areas in which suf-
ficient knowledge is available, but not put into practice. A narrative review was written to determine
areas in which more research is needed as well as areas in which sufficient knowledge is already
available. Attitudes, behaviour an self-effi- cacy of general practitioners, lung physicians and cardi-
ologists. General practitioners and medical assistants, dentists, cardiologists, pulmonary physicians,
general and pul- monary nurses, and physician s specialized in dealing with additive behavior, can
play a role in supporting pa- tients attempting to give up smoking. These differences could also
explain why fewer physicians indicated giving advice in the second study. This stabilization may be
a consequence of either lack of knowledge about effective ways to reduce smoking, or failed
treatment of tobacco addiction. In addition to revealing gaps in the current under- standing of
smoking cessation, our study showed that although sufficient knowledge is in fact available for a
number of areas, this knowledge is not - or at least not effectively - being applied in practice. Each
of the twelve core team members then judged these recommendations based on three dimen-. Future
research is needed to find ways to overcome these obstacles, for instance by investigat- ing the effect
of adequate funding for smoking cessation support. However, it is not possible to say whether
individual steps were not performed by physicians or simply not measured or reported by the
researchers. What are healthcare professionals currently doing ? Q 11. Call it Quits was a pragmatic,
parallel randomised trial of a case-worker delivered smoking cessation intervention conducted in a
non-government community social service organisation in New South Wales (NSW), Australia. This
study is based on the view that healthcare profes- sionals play an essential role in supporting
individuals who are trying to stop smoking. The available data on methods to prevent relapses from
occurring is limited and inconclusive, and therefore fur- ther study needs to be done on this topic.
3.6. Recommendations for Follow-Up Research - Delphi Procedure Based on the literature study,
various recommenda- tions for follow-up research were formulated. Smoking cessation in general
practice: the effects of a quitline. The remaining 35 articles were included in the final review. Whe n
interpreting the recommendations above, the reader should take into consideration the limitations of
this study. Why aren’t healthcare professionals doing more and how can this be improved. Smoking
habits of office-based general practitioners and internists in Austria and their smoking cessation
efforts.
Development of an instrument to document the 5A's for smoking cessation. On average, behavior
corresponding to the 5A’s was reported by 65% of physicians for “Ask”, 63% for “Advise”, 36% for
“Assess”, 44% for “Assist”, and 22% of physicians for “Arrange”, although the measurement and
reporting of each of these counseling practices varied across studies. This would help to further
understand and address common barriers. Call it Quits was a pragmatic, parallel randomised trial of
a case-worker delivered smoking cessation intervention conducted in a non-government community
social service organisation in New South Wales (NSW), Australia. Testing the reliability and
efficiency of the pilot Mixed Methods Appraisal Tool (MMAT) for systematic mixed studies review.
The fact that smoking is an addictive disease needs to be recognized by both smokers an d
healthcare professionals. Hispanic physicians' tobacco intervention practices: a cross-sectional survey
study. Furthermore, we thank Benjamin Strothmann for help as a student assistant and Klaus-Dieter
Papke for advice on the systematic database search. Physicians’ attitudes and reported practices
toward smoking intervention. For example, for the response options “Never”, “Occasionally”,
“Almost always” and “Always”, the proportions of physicians that selected “Always” were reported.
Most healthcare professionals recognise the importance of advising patients to stop smoking, but
experience certain barriers to actually do this. This study explored gaps in the current under- standing
of smoking cessation and the chal- lenges facing tobacco addiction management in order to
formulate recommendations for future research and healthcare practice. In addition to revealing gaps
in the current under- standing of smoking cessation, our study showed that although sufficient
knowledge is in fact available for a number of areas, this knowledge is not - or at least not
effectively - being applied in practice. Why aren’t healthcare professionals doing more and how can
this be improved. Theoretically, these specific elements could be used to create an improved, tailored
treatment. Main findings are that the first strategies “Ask” and “Advise” were more often reported
than the subsequent strategies “Assess”, “Assist” and “Arrange”. The authors feel strongly that the
greatest short-term gains in discouraging tobacco use can be made through healthcare professionals.
Attitudes, behaviour an self-efficacy of general practitioners, lung physicians and cardiologists.
Twenty-five articles reported “Advise” and on average, 63% of physicians (range: 13% to 99%)
advised their patients to stop smoking. This is worrying for many rea- sons including the fact that
smokers are dependent on a physician for many pharmacol ogical resources. How many smokers are
currently seeing healthcare professionals ? Q 7. Examples of other approaches are the ABC model (
Ask about and document smoking status, give brief advice and encourage the use of cessation
support) and the recommendation of the American Association of Family Physicians (AAFP; Ask
about tobacco use, advise to stop using tobacco products and provide behavioral interventions).
Eligible studies were those that measured physicians’ self-reported smoking cessation counseling
activities via questionnaire. This stabilization may be a consequence of either lack of knowledge
about effective ways to reduce smoking, or failed treatment of tobacco addiction. The available data
on methods to prevent relapses from occurring is limited and inconclusive, and therefore fur- ther
study needs to be done on this topic. 3.6. Recommendations for Follow-Up Research - Delphi
Procedure Based on the literature study, various recommenda- tions for follow-up research were
formulated. While instruments to assess smoking cessation counseling have been developed in
relation to the 5A’s strategy, these instruments require additional evaluation. One reviewer (ALBa)
performed the initial data extraction and a second reviewer (BS) checked whether the data were
extracted accurately. Are primary care physicians prepared to assist patients for smoking cessation.
This article outlines the study’s principal findings and provides recommendations for follow-up
research and healthcare practice. A narrative review was written to determine areas in which more
research is needed as well as areas in which sufficient knowledge is already available.
The search strategy was then adapted in order to perform an extensive literature search in the
following databases: Embase, Medline and PsycINFO via OVID as well as CINAHL and the
Cochrane library (Please see S1 File for the detailed search strategy per database). Why aren’t more
smokers seeing healthcare professionals and how can this situation be improved. Most healthcare
professionals recognise the importance of advising patients to stop smoking, but experience certain
barriers to actually do this. Attitudes, gedrag en eigen effectiviteit van huisartsen, longartsen en
cardiologen. Testing the reliability and efficiency of the pilot Mixed Methods Appraisal Tool
(MMAT) for systematic mixed studies review. It is largely unclear how structural care for smokers
can be embedded in the Du tch healthcare system. However, it is not possible to say whether
individual steps were not performed by physicians or simply not measured or reported by the
researchers. In contrast, other studies included questionnaires developed by the researchers during
project group discussions or expert consultations (e.g. in-depth interviews). The patient exit interview
as an assessment of physician-delivered smoking intervention: a validation study. The following
information was extracted: study identifiers (Author, year, and country), the sample (physician
characteristics), the methods (data collection method) and results (response rate, sample
characteristics and smoking cessation counseling behavior). Therefore, the aim of this literature
review is to systematically assess physician-reported smoking cessation counseling in primary care by
classifying counseling practices according to the 5A’s strategy. Smoking cessation in general practice:
the effects of a quitline. Twenty-five articles reported “Advise” and on average, 63% of physicians
(range: 13% to 99%) advised their patients to stop smoking. This stabilization may be a consequence
of either lack of knowledge about effective ways to reduce smoking, or failed treatment of tobacco
addiction. Physician smoking status, attitudes toward smoking, and cessation advice to patients: an
international survey. Why aren’t healthcare professionals doing more and how can this be improved.
What are healthcare professionals currently doing ? Q 11. The database search was limited to studies
published between 2000 and June 2015 because counseling behavior was categorized according to
the 5A’s strategy, which was published by the US Public Health Service in the year 2000 and the
literature search was conducted in June 2015. Increasing knowledge about genetic disposi- tion to
smoking addiction may make it easier to choose individualized treatment in the future. 3.3.
Opportunities for Healthcare Professionals If a healthcare professional advises a smoker to stop, this
carries more weight than when such advice comes. However, comparability of quantitative
information on smoking cessation counseling practices was limited and it is not clear which
counseling steps are implemented in practice. Knowledge and perceived effectiveness of cessa- tion
assistance as predictors of cessation behavior. ABSTRACT Despite ongoing efforts to reduce tobacco
smo- king, the smoking prevalence in many countries has remained stable for years. Fourteen articles
reported “Arrange” and on average 22% (range: 2% to 54%) of physicians arranged follow-up
consultations. Toronto, Canada: Canadian Action Network for the Advancement, Dissemination and
Adoption of Practice-informed Tobacco Treatment, Centre for Addiction and Mental Health.; 2011.
Available from:. 64. On average, behavior corresponding to the 5A’s was reported by 65% of
physicians for “Ask”, 63% for “Advise”, 36% for “Assess”, 44% for “Assist”, and 22% of
physicians for “Arrange”, although the measurement and reporting of each of these counseling
practices varied across studies. During the first round of the Del- phi procedure, each core team
member individually produced his or her own top-10 list of recommendations. Funding: This
literature review was conducted in the context of the study ENTER, which is funded by the German
Federal Ministry of Health ( ) under registration code IIA5-2513DSM231. Importance relates to its
overall importance to society, and imp act refers to what effect it will have on an individual level.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Informa- tion was gathered from the “Tobacco Addiction” topic in the Cochrane Database of
Systematic Reviews, publica- tions from STIVORO and the Dutch National Institute for Public
Health and the Environment (RIVM), as well as from the personal archives of the core team
members.
Consultation with a healthcare professional to stop smoking Q 5. It is not possible to simply state
what the best smoking cessation intervention is, since individual factors such as motivation, self-
confidence, degree of addiction, age, and socioeconomic status all influence attempts to stop
smoking. Thirty-five articles were included in the final review (1 intervention and 34 cross-sectional
studies). Speed refers to how quickly the recommen- dation will lead to relevant results (more
successful smo- king cessation attempts). The following information was extracted: study identifiers
(Author, year, and country), the sample (physician characteristics), the methods (data collection
method) and results (response rate, sample characteristics and smoking cessation counseling
behavior). Second, care for smokers should be structurally embedded in the health-. Physicians’
attitudes and reported practices toward smoking intervention. In addition to revealing gaps in the
current under- standing of smoking cessation, our study showed that although sufficient knowledge
is in fact available for a number of areas, this knowledge is not - or at least not effectively - being
applied in practice. Competing interests: The authors have declared that no competing interests exist.
In contrast, other studies included questionnaires developed by the researchers during project group
discussions or expert consultations (e.g. in-depth interviews). Details of the quality assessment are
shown in S4 File. A Delphi procedure was used to create a top-15 list of recommen- dations.
Research questions were created for each phase in the cycle and are listed in Table 1. 2.2. Literature
Study The research questions were subsequently used to identify what determines the success or
failure of an attempt to stop smoking at a specific juncture, what we already know about this from
both Dutch and interna- tional literature, and what we have yet to learn. What are healthcare
professionals currently doing ? Q 20. All of these interventions appear to be cost-effective; initial
investments in smoking cessation support will in the long term reduce the total costs of smoking-
related illnesses. However, research suggests that smoking cessation counseling is not sufficiently
implemented in primary care. The strategies “Ask” and “Advise” were most frequently reported.
“Ask” was reported in 29 articles and on average 65% (range: 7% to 100%) of physicians asked
about their patient’s smoking behavior. Why aren’t healthcare professionals doing more and how can
this be improved. Theoretically, these specific elements could be used to create an improved, tailored
treatment. Physician smoking status may influence cessation counseling practices. First, it is
important that smokers turn to a healthcare professional to obtain support in stopping smoking. One
effective approach to tobacco control is smoking cessation counseling by primary care physicians.
Eligible studies were those that measured physicians’ self-reported smoking cessation counseling
activities via questionnaire. Therefore, the aim of this literature review is to systematically assess
physician-reported smoking cessation counseling in primary care by classifying counseling practices
according to the 5A’s strategy. The subject is too wide-ranging for a systematic review and it would
not be possible to determine what knowl- edge is lacking using such a method. Pulmonary physicians
and cardi- ologists most often see patients with medical problems resulting from smoking. Why
aren’t healthcare professionals evaluating their policies and their results more and how can this
situation be improved. This reinforces the idea that smokers do not actually need help when trying to
stop. The funders had no role in study design, data collection and analysis, decision to publish, or
preparation of the manuscript. If all healthcare professionals systematically ad- vise their patients to
give up smoking, eventu- ally more smokers will successfully stop smo- king.
What are healthcare professionals currently doing ? Q 20. This trial aimed to examine the
effectiveness of an intervention (Call it Quits) developed to promote smoking cessation and
delivered by community social service case-workers. Overall, healthcare profession- als need to be
convinced that tobacco smoking is an addiction and should be treated likewise. In addition to
revealing gaps in the current under- standing of smoking cessation, our study showed that although
sufficient knowledge is in fact available for a number of areas, this knowledge is not - or at least not
effectively - being applied in practice. The core search strategy was developed using the keywords
and relevant synonyms to capture smoking cessation counseling by physicians and reviewed by a
librarian experienced in database searches. Attitudes and behaviours in smoking cessation among
general practitioners in Finland 2001. During the first round of the Del- phi procedure, each core
team member individually produced his or her own top-10 list of recommendations. In the case of
rating scales, we reported the responses to the end point of the scale. Also, physicians who
participate in surveys on smoking cessation counseling may be more interested and hence more
engaged in counseling activities than the overall population of physicians. If multiple forms of
assistance were reported (e.g. prescribing NRT, handing out leaflets, referral to expert), we reported
only the most frequently offered form of assistance. Why is it important to create a smoker’s profile
? Q 9. As outlined earlier, this publication focuses on the role of healthcare professionals, and
therefore other solutions to reduce smoking were not given a great amount of attention. Main
findings are that the first strategies “Ask” and “Advise” were more often reported than the
subsequent strategies “Assess”, “Assist” and “Arrange”. This stabilization may be a consequence of
either lack of knowledge about effective ways to reduce smoking, or failed treatment of tobacco
addiction. What are the effects of interventions carried out by people from the smoker’s
environment ? Q 4. A preliminary search of Medline via OVID served to identify relevant keywords.
Hispanic physicians' tobacco intervention practices: a cross-sectional survey study. Do these Subject
Areas make sense for this article. Further articles were identified by screening the bibliographies of
articles retrieved from the initial search. Studies for which all items on the checklist were answered
with “yes” were included in the review. Any discrepancies were resolved by discussion until
consensus was reached. MIRO is a care optimization program in which smoking cessation experts in
the Netherlands work together. Secondary findings are that the proportions of physicians reported
differed considerably per 5A strategy. The database search was limited to studies published between
2000 and June 2015 because counseling behavior was categorized according to the 5A’s strategy,
which was published by the US Public Health Service in the year 2000 and the literature search was
conducted in June 2015. Delivery of preventive care: the national Canadian Family Physician Cancer
and Chronic Disease Prevention Survey. Why is it important to evaluate the smoking cessation policy
and its results ? Q 19. This takes little time and will eventu- ally lead to more people stopping
smoking. 4. DISCUSSION The information obtained from the present literature study has led to a
number of recommendations for fol- low-up research, which were subsequently prioritized using a
Delphi procedure. Each of the twelve core team members then judged these recommendations based
on three dimen-. Smoking behavior and opinions of French general practitioners. Proposal: A mixed
methods appraisal tool for systematic mixed studies reviews.
General practitioners and medical assistants, dentists, cardiologists, pulmonary physicians, general
and pul- monary nurses, and physician s specialized in dealing with additive behavior, can play a role
in supporting pa- tients attempting to give up smoking. In the smoking cessation cycl e, presented in
figure 1, three phases seem to be es sential in the success of an attempt to stop. Use of medical
counseling for the prevention and control of smoking in the municipality of old Havana. How many
people who attempt to stop smoking persist in their own environment ? Q 16. Physician assessment
of patient smoking in Indonesia: a public health priority. However, it is not possible to say whether
individual steps were not performed by physicians or simply not measured or reported by the
researchers. Details of the quality assessment are shown in S4 File. INTRODUCTION Today almost
everyone in the world is aware of the adverse health consequences of smoking, and studies of ways
to reduce smoking are numerous. Overall, healthcare profession- als need to be convinced that
tobacco smoking is an addiction and should be treated likewise. Healthcare professionals should also
systemically advise their patients who smoke to stop and offer smoking ces-. Examples of other
approaches are the ABC model ( Ask about and document smoking status, give brief advice and
encourage the use of cessation support) and the recommendation of the American Association of
Family Physicians (AAFP; Ask about tobacco use, advise to stop using tobacco products and
provide behavioral interventions). The authors feel strongly that the greatest short-term gains in
discouraging tobacco use can be made through healthcare professionals. After all, every person who
wants to stop smoking has a right to the most appropriate, customized treatment for his or her
addiction. 5. CONCLUSIONS Overall, healthcare professiona ls need to be convinced that tobacco
smoking is an addiction and should be treat- ed likewise. The patient exit interview as an assessment
of physician-delivered smoking intervention: a validation study. Changes in health care policy and
clinical guidelines affect provider behaviour and may influence the frequency and type of smoking
cessation counseling. For many, treat- ing smoking addiction is not a top priority, possibly due to a
lack of adequate funding. 3.5. Relapse Overcoming a tobacco addiction is typically accom- panied
by physical and psychological withdrawal symp- toms that increase the likelihood of a relapse.
Healthcare professionals who already are involved in smoking cessation support experience various
obstacles. Main findings are that the first strategies “Ask” and “Advise” were more often reported
than the subsequent strategies “Assess”, “Assist” and “Arrange”. General practitioners are the least
convinced that smo- king is an addiction that requires the help of healthcare professionals, compared
to cardiologists, pulmonary phy- sicians, pulmonary nurses, and medical assistants. ABSTRACT
Despite ongoing efforts to reduce tobacco smo- king, the smoking prevalence in many countries has
remained stable for years. This has resulted in two recommendations for healthcare practice, each
confirmed by the experts from the MIRO core team. Twenty-three articles reported “Assist”, with
an average of 44% (range: 2% to 98%) of physicians providing assistance. Journal of applied
psychology. 2003;88(5):879. pmid:14516251. Consultation with a healthcare professional to stop
smoking Q 5. Any discrepancies were resolved by discussion until consensus was reached. Physician
smoking status, attitudes toward smoking, and cessation advice to patients: an international survey.
Why aren’t more smokers seeing healthcare professionals and how can this situation be improved.
Smoking habits of office-based general practitioners and internists in Austria and their smoking
cessation efforts. This article outlines the study’s principal findings and provides recommendations
for follow-up research and healthcare practice. Tobacco use, cessation advice to patients and
attitudes to tobacco control among physicians in Ukraine.