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Physicians who skip counseling patients to stop smoking are missing an opportunity to help their patients quit—even if those patients are less engaged during medical visits, according to a new study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR) published online in JAMA Internal Medicine.
Nationally, less than half of adult smokers report that their physicians advise them to stop smoking, while about two-thirds of physicians say lack of patient motivation to quit smoking is a barrier to medical interventions.
The JAMA Internal Medicine study, titled “Patient Engagement During Medical Visits and Smoking Cessation Counseling,” examined the relationship between patient engagement—or how involved people are in their health care—and the likelihood that physicians would counsel patients to stop smoking.
The study by Peter Cunningham, Ph.D., of Virginia Commonwealth University, was conducted for NIHCR while he was a senior fellow at the former Center for Studying Health System Change. Based on a 2012 survey of 8,656 current and retired autoworkers and their spouses younger than 65, the study included 1,904 current smokers and assessed their engagement levels depending on whether they had ever talked with their physician about health information they found on the Internet, had someone accompany them to a medical visit for support, had taken notes during a medical visit to help remember what was said, and had brought a list of questions to ask during a medical visit.
Highly engaged patients were more likely to report that their physicians had advised them to stop smoking, the study found. And, highly engaged patients whose physicians counseled them to stop smoking were the most likely to attempt to quit (75%), while patients with low engagement levels who did not receive counseling were the least likely to attempt quitting (46%). However, if counseled by their physician, 60 percent of smokers with low engagement levels attempted to quit smoking, the study found.
“Clinicians should not misinterpret lack of patient engagement during medical encounters as unwillingness to quit because the results of this study suggest that counseling of even less engaged patients is effective in getting them to attempt quitting,” the article states.
The findings strongly suggest “that clinicians respond differently to patients who are highly engaged during medical encounters than they do to less engaged patients in terms of advising patients to stop smoking. Nevertheless, even patients with low levels of engagement can benefit from this counseling,” the article concludes.