General Practitioners' views on the English national smoking cessation guidelines

Objectives. Several countries have followed the US example in publishing national guidelines on smoking cessation interventions. Gauging responses to these guidelines can provide important lessons for future implementation and revision internationally. This study sought to assess General Practitioners' (GPs') views on recently published English smoking cessation guidelines that form the foundation of the UK National Health Service's smoking cessation strategy. Design. Postal survey in which GPs were asked to judge the appropriateness, effectiveness and practicability of key recommendations for primary care in recent national smoking cessation guidelines. Setting. General practice, England and Wales. Subjects. Random national sample of GPs; 236 GPs completed the questionnaire; effective response rate: 62%. Results. Only 16% of GPs accepted that all the recommendations in the guidelines were appropriate; 43% accepted that it was appropriate to check the smoking status of known smokers when they visit the surgery and only 30% thought it was practicable to advise smokers to stop at every opportunity. However, 77% of GPs thought that they should provide assistance for smokers wanting to stop; 74% believed that they should refer smokers to specialist services if appropriate and a similar proportion (77%) believed that it was appropriate to recommend nicotine replacement therapy. Conclusions. There was greater acceptance by GPs that they should assist smokers wanting to stop than that they should routinely monitor smoking status and give opportunistic advice to patients to stop. Given that opportunistic advice is a cornerstone of the national guidelines there is a need to find ways of reconciling what is being recommended and what GPs feel is appropriate.