French general practitioners' attitudes and reported practices in relation to their participation and effectiveness in a minimal smoking cessation programme for patients

Aims. To examine the participation and effectiveness of GPs in offering a minimal smoking cessation intervention according to attitudinal and reported behaviour variables. Design. General practitioners were surveyed about their practices and attitudes and then matched pairs of smoking and non-smoking doctors were invited to participate in a regional smoking cessation intervention. The relationship of survey responses and the degree of participation and effectiveness in a smoking cessation trial was examined. Setting. Primary care doctors in a large region of southern France, Provence-Alpes-Cote d'Azur (PACA). Participants. Two thousand, eight hundred and sixty GPs from the PACA region in France were interviewed about their attitudes and behaviours. Front among 371 smoking GPs and 375 non-smoking GPs invited to take pan in a smoking cessation trial with patients, 170 smokers and 202 non-smokers participated. Measurements. The GPs' attitudes and reported professional and personal practices were assessed in a telephone interview. These responses were compared with the GPs' participation in the cessation trial, and with GP "success" (I or more patients stopping smoking at I month, 12 months or both) or "non-success" (no patient cessation at I month or at 12 months). Findings. A significantly lower proportion of smokers than non-smokers among the GPs who initially accepted did not participate in the study (45% vs. 54.1 %, chi(2) = 5.147 df = I, p < 0.05, difference: 8.3% 95% CI: 1.2%; 15.5%), but thereafter, there were no significant associations between GPs' reported smoking practices and attitudes and the extent of their participation or effectiveness. Conclusions. The study results indicate that, when minimal advice has an effect, it is due more to the systematic nature of the provision of the intervention than to the attitudes or reported practices of the practitioner providing the advice.