Knowledge and management of smoking-cessation strategies among cardiologists in France: A nationwide survey

Background. - White cardiologists are very active in the prevention of cardiovascular disease, their attitudes towards patients' smoking habits are poorly studied. Aims. - In a nationwide French survey, we assessed cardiologists' levels of knowledge and management of smoking cessation. Methods. - We sent out a questionnaire to a random sample of 1000 cardiologists. Results. - A total of 371 cardiologists agreed to participate in the survey; 8.1% were current smokers and 32.4% were past smokers. Most classified smoking cessation as the top priority for patients with coronary artery disease (56.5%) and peripheral arterial disease (88.5%). Cardiologists routinely assessed active and passive smoking in 96.2% and 43% of their patients, respectively. Only 29.2% considered themselves well informed about smoking-cessation management. White 39.9% declared they knew about the minimal counselling 7.3% described it correctly. Only 17.5% used the Fagerstrom questionnaire. Smoking cessation was advised systematically by 85% but only 5.4% of cardiologists followed up their patients specifically on this issue. They referred smokers to either their general practitioner or to smoking-cessation centres and/or quitlines in 16.0% and 67.0% of cases, respectively; 31.8% never referred their patients to a smoking-cessation centre, and 25% declared being unaware of any such centre in their area. Cardiologists who smoked were less likely to ask about patients' smoking status than non-smokers (90% vs 98.2%, p = 0.039). Similarly, they were more passive in offering smoking-cessation counselling (23% vs 7%, p=0.011), and referred less frequently their patients to a smoking-cessation centre (37% vs 64%, p = 0.028). Conclusion. - French cardiologists are rarely involved in the management of smoking cessation. Their own smoking status influences their attitudes towards the management of smoking cessation. (C) 2009 Published by Elsevier Masson SAS.