Making time for tobacco cessation counseling

Background. The objective of this study was to examine the incidence, targeting, and time demands of tobacco cessation advice by community family physicians. Methods. Research nurses directly observed 2 days of outpatient visits to 138 family physicians in northeast Ohio. Smoking status was identified by patient questionnaire. Visit characteristics were determined from direct observation and billing data. Visits by smokers with and without smoking cessation advice were compared. Results. The incidence of tobacco cessation advice was highest during wellness visits (55% vs 22% for illness visits; P < .001). Smokers seen for a tobacco-related chronic illness were more likely to receive advice than those seen for a chronic problem not related to tobacco (32% vs 17%; P=.05). The average duration of advice was less than 1 1/4 minutes. There were no significant differences in the duration of advice across different types of visits. Conclusions. Physicians are providing brief, targeted interventions for smoking cessation in family practices. The findings support the feasibility of implementing a brief intervention with all smokers seen during office visits.