Smoking behaviour before and after attendance at a health promotion clinic in general practice

Abstract

A NURSE-RUN health promotion clinic in general practice was established in 1983 in a 12,000-patient suburban Oxford practice. The smoking behaviour of patients before and after attending this clinic has been audited. Two years and six months after the establishment of the clinic, 1470 patients had been invited and 1382 (94 per cent) had attended. Each had received an explicit anti-smoking intervention from the practice nurse. In 1987, 1172 of these remained in the practice area and were mailed questionnaires. Nine hundred and thirty-one (79.4 per cent) returned a completed questionnaire. Of the 183 patients who had reported cigarette smoking at the health check, 57 (31.1 per cent) claimed they had stopped smoking cigarettes, but 22 (12.2 per cent) of them had changed to smoking another form of tobacco. Of the 748 patients who said at the health check they did not smoke cigarettes, 19 (2.5 per cent) reported that they now smoked cigarettes. In the study population there was a net reduction of 38 (3.2 per cent) in cigarette smokers and of 14 (1.2 per cent) smokers of all forms of tobacco. Many reports of smoking cessation interventions describe the proportion of cigarette smokers who stop smoking cigarettes, but take no account of other forms of tobacco use, or of non-smokers who start smoking. These studies may have led to an over-benefits of practice-based anti-smoking strategies.