Smoking cessation practices of Dutch general practitioners, cardiologists, and lung physicians

STUDY OBJECTIVES: To assess and compare the smoking cessation practices and smoking behavior of Dutch general practitioners (GPs), cardiologists, and lung physicians. METHODS: We conducted questionnaire surveys among a random sample of 2000 Dutch GPs, all Dutch cardiologists (N=594), and all Dutch lung physicians (N=375). RESULTS: In total, 834 GPs (41.7%), 300 cardiologists (50.5%), and 258 lung physicians (68.8%) filled out and returned the questionnaire. The prevalence of current smokers was 8.2% among GPs, 4.3% among cardiologists, and 3.5% among lung physicians. Of the pharmacological aids for smoking cessation, physicians recommended bupropion most frequently, followed by nicotine patches and nicotine gum. More lung physicians recommended the use of these three aids (67.0%, 36.3% and 18.2%, respectively) than GPs (65.7%, 18.7% and 9.8%, respectively), and than cardiologists (31.6%, 19.7% and 13.2%, respectively). A higher proportion of lung physicians (69.3%) had referred at least one smoker to a nurse for smoking cessation treatment than cardiologists (25%), and than GPs (11.3%). CONCLUSIONS: Based on this national survey, one may conclude that the prevalence of current smoking among Dutch physicians is relatively low and has further decreased since 1988. Dutch GPs, cardiologists, and lung physicians mainly use interventions for smoking cessation that are easy to administer and are not very time consuming. Furthermore, more lung physicians than GPs and cardiologists recommend the use of bupropion, nicotine patch, and nicotine gum. When designing interventions for smoking cessation, one should take into account that physicians are often reluctant to provide interventions which demand much time. Therefore, intensive counseling of smokers who want to quit smoking may be more feasible for trained non-physicians, such as nurses.