General Practitioner Interventions for Smoking Cessation: Past Results and Future Prospects

Abstract

General practice is a critical setting for the identification, assessment, treatment, follow-up and onward referral of smokers. General practitioners (GPs) are in a unique position to play a part in reducing preventable morbidity and mortality attributable to tobacco use. During the past decade, numerous trials have been conducted in general practice and have shown that GP intervention with smokers has a variable degree of success depending on the intensity of contact. Although there are many positive reasons for GP involvement, there are also barriers to implementing smoking cessation strategies in general practice. In this paper we discuss some of these issues. The Stages of Change framework developed by Prochaska and DiClemente (1986) has been used to describe the stages a smoker goes through in the process of becoming a non-smoker. However, the incorporation of smoking cessation interventions in a GP's routine practice also involves a process of psychological change. In this paper, therefore, we apply the Stages of Change model to GPs' recognition, uptake and maintenance of smoking cessation interventions.