Health professional training essential to reduce tobacco reliance

Health care professionals do a better job helping people quit smoking when they are trained in smoking cessation techniques, a new Cochrane Library review finds.

Smoking cessation training helped health care providers identify interventions that help smokers quit. "The vast majority of health professionals would ask about smoking status, yet very few would offer advice or support to quit," said Kristin Carson, medical research specialist at the Queen Elizabeth Hospital in Adelaide, Australia. Providers cited a lack of time, confidence and more pressing health priorities as reasons for not offering such advice, the study found.

Carson and her colleagues reviewed 17 clinical trials to assess the success of smoking cessation programs of more than 1,700 health professionals and 28,500 patients.

Training of health care providers, defined as doctors, dentists, nurses and pharmacist, ranged from one 40-minute session to a five-day workshop. "Overall, the interventions were not overly expensive, difficult to implement or time-consuming," Carson said. Trained health care providers were more likely to ask patients to set a quit date, make follow-up appointments, counsel smokers and provide self-help materials.

Doctors and other providers can strongly influence smoking habits as nearly 80 percent of individuals visit a primary care provider at least once a year, Carson notes. She called for smoking cessation intervention training to be integrated into routine medical education for all doctors and dentists.

Health professional training is "essential" to reducing tobacco reliance, said Wendy Bjornson, co-director of the Oregon Health & Science University Smoking Cessation Center.

"While most health professionals recognize the importance of advising patients to stop smoking, many of them do not know how to help smokers beyond telling them they should quit," Bjornson said.

Health providers also need tools within their practices to help hold patients accountable such as setting up referrals for cessation support services. Without such systems, she said it's difficult to help patients regardless of training.