A survey of Massachusetts physicians' smoking intervention practices.

Attitudes toward smoking intervention, and the intervention practices of 65 residents, 51 attending physicians, and 292 community physicians in central and western Massachusetts were assessed through a mailed questionnaire. Nearly all physicians reported that they obtained information on the smoking status of new patients and told smokers to quit. Proportionately fewer physicians, however, reported that they counseled their patients on how to stop smoking; those who did, did so for relatively brief periods of time. After differences in physician age and smoking status were controlled for, residents were significantly more likely than attending physicians to counsel their patients on how to stop smoking, but were also more likely (than attending and community physicians) to recommend or refer their patients to formal smoking cessation programs. A small percentage of the physicians responding (3%-16%) reported that they were prepared to counsel smokers, but most reported that information on where to refer patients, smoking cessation techniques, and skills training would be of great value. The results of this survey suggest practical differences between residents and attending and community physicians in approaching patients who smoke and in attitudes toward the need for additional skills and financial and organizational assistance.