The development of a decisional balance measure of physician smoking cessation interventions

Background. Decreasing the prevalence of smoking is an important health care goal, and there is evidence that physicians' advice to quit is an important motivator for patients. However, fewer than half of smokers report that they have ever been advised to quit. This study was conducted to develop a decisional balance measure for physician delivery of smoking cessation interventions. Methods. This study included a convenience sample of 155 primary care physicians. A decisional balance measure was developed using item generation and development, pilot testing, and principal components analyses. Validity was established by relating the deci-sional balance measure to a previously validated item of counseling behavior and to physician stage of readi-ness to deliver smoking cessation counseling. Results. Based on principal components analyses and item analyses, the final measure consisted of 10 Pro and 10 Con items with coefficient a of 0.83 and 0.86. The Pros and Cons scales were significantly associated with self-reported counseling to patients who smoke and to stage of readiness to deliver smoking cessation counseling. Conclusions. A decisional balance measure of physician smoking cessation interventions can be used to assist investigators in developing effective interventions to enhance the delivery of smoking cessation interventions in primary care settings. (C) 2001 American Health Foundation and Academic Press.