Advocacy and policy news for internists

Physicians Urged to Be More Active in Getting Patients to Quit Smoking

The American College of Physicians has joined a nationwide effort by the Centers for Disease Control and Prevention to encourage conversations between smokers and their doctors about quitting tobacco use.

"It's a huge public health issue, and it's an area where internists can really improve the health of their patients," said Dr. Charles Cutler, chairman of the ACP Board of Regents. "There's so much in medicine that's beyond the control of physicians, but here is an opportunity to prevent so many cases of cancer and emphysema and throat illnesses and pneumonia. It really is an unusual opportunity within the profession to do something important for patients."

Every physician should consider taking part in this effort, called the "Talk With Your Doctor" initiative, Cutler said.

It's the second phase of CDC's national tobacco education campaign. The first phase featured former smokers sharing their stories about how tobacco use harmed their health. In the second phase, launched in late May, the emphasis will shift to encouraging current smokers to reach out to their doctor for help.

"Every doctor can help their patients quit, and every doctor should do everything possible to help their patients quit," Dr. Tom Frieden, the CDC director, said during a news conference on the new initiative, which also will include advertisements urging smokers to seek help and advice from their physician about quitting.

Medical groups representing nearly 600,000 physicians have agreed to take part. ACP's colleagues in this effort include the American Academy of Pediatrics, American Medical Association, American Academy of Family Physicians, and American College of Obstetricians and Gynecologists.

About one in five U.S. adults is a cigarette smoker, amounting to 43.8 million people, a percentage that has shown no sign of movement in recent years. "Progress has stalled," U.S. Surgeon General Regina J. Benjamin admitted during the news conference.

But the CDC reports that more than 70 percent of smokers want to quit, and about 50 percent try to quit each year. Research has shown that physicians can play a decisive role in their struggles. Frieden said that advice from a doctor more than doubles the chances that a patient will successfully quit.

The "Talk With Your Doctor" initiative includes a number of free resources provided by the CDC through its website. These include:

  • Clinic waiting room posters.
  • A fact sheet that provides helpful talking points for patient conversations.
  • A video commentary by Dr. Timothy McAfee, director of CDC's Office on Smoking and Health, that offers step-by-step instructions on how to conduct a brief tobacco intervention.
  • An FAQ explaining how tobacco quit lines work.
  • A continuous-looped video designed for use in waiting rooms.
  • A printable pocket script card to assist physicians when talking with patients about quitting.

Talking with a patient about smoking might seem a bit daunting, given that some people can become defensive about an addictive behavior, but Cutler said it's not that difficult to broach the subject.

"I don't think patients are as sensitive about having the discussion as one might think," he said. "I think they are frightened about it. They recognize the difficulty in breaking a habit they've been participating in for years and years. But I think they appreciate doctors bringing the subject up and offering advice on how to quit using tobacco products."

More information

Information on resources for physicians that are part of the "Talk With Your Doctor" campaign are available on the CDC website.

Guidelines on counseling to prevent tobacco use are available from the U.S. Preventive Services Task Force.

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June 6 2013
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