Study finds that physicians help patients quit smoking but could provide more education

Physicians are an important resource in New Jerseyans’ fight to stop smoking, but they can and should become even more effective educators, according to a survey by the Center for State Health Policy (CSHP) at Rutgers, The State University of New Jersey.

The survey of more than 84,000 physicians practicing patient care in New Jersey found that while a large proportion of primary care physicians are aware of and refer patients to state-sponsored smoking cessation programs, awareness of and referral to these resources were lower in some groups of doctors, including some specialists likely to see many smokers, such as psychiatrists and oncologists, as well as older, male and nonteaching physicians.

Among physicians surveyed, slightly more than one-third knew of the smoking cessation programs and, among the knowledgeable physicians, about 60 percent referred patients to them.

“Physicians have an important role in communicating with their patients about smoking and creating an awareness of the risks associated with tobacco use,” said Joel C. Cantor, CSHP’s director. “While many physicians are helping their patients quit, evidence suggests that many physicians could do more.” He noted that a previous survey published in the Journal of the American Medical Association had found that only 21 percent of practicing physicians said they had received adequate training to help their patients stop smoking. In addition, only half of current smokers reported they had received advice about quitting from a physician.

The Rutgers’ study utilized data from the New Jersey State Physician Census, conducted by CSHP in collaboration with the New Jersey Board of Medical Examiners and the New Jersey Commission on the Physician Workforce. The census, conducted from June through October 2002, by mail, Web and telephone, was designed to identify characteristics and attitudes of doctors licensed to practice in the state. The response rate was 26.6 percent, or 8,150 doctors. The smoking analysis was limited to 4,351 physicians practicing patient care in New Jersey.

In gauging doctors’ responses to patients who smoked, the survey asked physicians if they were familiar with smoking cessation programs and whether they had ever referred a patient to such programs as New Jersey’s Internet-based Quitnet or telephone hotline Quitline established by the Department of Health and Senior Services.

The research found that among primary care specialties — family practice, internal medicine, OB/GYN and pediatrics — awareness of Quitnet and Quitline ranged from 65.6 percent (family practice) to 48.8 percent (OB/GYN). Almost two-thirds of the practitioners in those two specialties who were aware of the state-supported services (64.5 percent and 66.3 percent, respectively) referred patients. While only about half (51.6 percent) the internists knew of Quitnet and Quitline, 63.4 percent of those referred patients.

Among the tobacco-sensitive specialties, practitioners in pulmonary disease (72.1 percent) and cardiovascular disease (60.6 percent) had the strongest awareness of the two services and referred 71.4 percent and 64.9 percent of their patients, respectively. While only about one-third of specialists in radiology oncology knew of the programs, two-thirds of those who did made patient referrals.

After the radiology oncologists, psychiatrists and medical oncologists had the least knowledge of smoking cessation programs (21 percent and 42 percent, respectively, knew of such programs). Nevertheless, among those familiar with the programs, 65 percent of the psychiatrists and 60 percent of the medical oncologists made referrals.

Rutgers’ Center for State Health Policy impartially informs, supports and stimulates sound and creative state health policy in New Jersey and around the nation. Established in 1999, the center is a research unit within the Institute for Health, Health Care Policy and Aging Research.