College of Public Health, University of Arkansas for Medical Sciences, Little Rock, 72205-7199, USA.
Am J Med Sci. 2012 May;343(5):388-96. doi: 10.1097/MAJ.0b013e3182302749.
Tobacco use greatly contributes to overall socioeconomic health disparities, and physicians are a major source of information about effective methods for tobacco cessation. This study examined the tobacco intervention practices of primary care physicians in Arkansas who treat a high proportion of lower socioeconomic status patients. More than 70% of respondents' patients were covered by Medicaid and/or Medicare or paid for primary care services without health insurance. Although physicians were highly motivated and considered cessation to be very important, 74% had no training of any kind in the treatment of tobacco dependence and familiarity with the free treatment services in Arkansas was low. Younger and nonwhite physicians and physicians with any type of training in treating tobacco dependence reported more positive attitudes, more frequent intervention behaviors and more familiarity with treatment services. More frequently seeing the effects of tobacco use on the health of patients as well as increased knowledge, preparedness, and perceived effectiveness of treatments were related to a higher frequency of providing cessation assistance. More frequently seeing the effects of tobacco use on patients, as well as increased familiarity with treatment services were related to a higher frequency of referring patients to treatment services. These findings suggest that training experiences that increase physician awareness of the multiplicity of consequences of tobacco use as well as increase knowledge, preparedness, perceived effectiveness of treatments and familiarity with treatment services will increase the frequency with which physicians assist and refer this important patient population.
吸烟大大加剧了整体社会经济健康差距，而医生是提供有效戒烟方法信息的主要来源。本研究调查了阿肯色州的初级保健医生在治疗社会经济地位较低的患者方面的烟草干预实践。超过 70%的受访者的患者由医疗补助计划和/或医疗保险覆盖，或者在没有健康保险的情况下支付初级保健服务费用。尽管医生的积极性很高，认为戒烟非常重要，但 74%的医生没有接受过任何形式的烟草依赖治疗培训，对阿肯色州的免费治疗服务也不熟悉。年轻和非白人医生以及接受过任何类型的烟草依赖治疗培训的医生报告说，他们的态度更积极，干预行为更频繁，对治疗服务更熟悉。更频繁地看到吸烟对患者健康的影响，以及增加对治疗的了解、准备和有效性的认知，与提供戒烟帮助的频率更高有关。更频繁地看到吸烟对患者的影响，以及对治疗服务的熟悉程度与更频繁地将患者转介到治疗服务有关。这些发现表明，增加医生对吸烟多种后果的认识的培训经验，以及增加对治疗的了解、准备、有效性认知和对治疗服务的熟悉程度，将增加医生帮助和转介这一重要患者群体的频率。
