Comparison of smoking habits, knowledge, attitudes and tobacco control interventions between primary care physicians and nurses
More details
Hide details
Department of Family Medicine, Duzce University, School of Medicine, Duzce, Turkey
Department of Chest Diseases, Duzce University, School of Medicine, Duzce, Turkey
Community Health Center, Isparta, Turkey
Department of Neurology, Duzce University, School of Medicine, Duzce, Turkey
Community Health Center, Duzce, Turkey
Cukurca State Hospital, Hakkari, Turkey
Poturge State Hospital, Malatya, Turkey
Tuzla Family Health Center, Istanbul, Turkey
Submission date: 2015-05-20
Acceptance date: 2015-11-04
Publication date: 2015-11-12
Corresponding author
Cemil Isik Sonmez   

Department of Family Medicine, Duzce University, School of Medicine, Duzce, Turkey
Davut Baltaci   

Department of Family Medicine, Duzce University, School of Medicine, Duzce, Turkey
Tobacco Induced Diseases 2015;13(November):37
Primary care providers are uniquely positioned to initiate smoking cessation. We aimed to evaluate knowledge levels about the health effects of smoking and attitudes toward smoking and tobacco control activities among primary care providers.

In the cross-sectional and primary care-based study, self-administered surveys modified from the WHO Global Health Professional Survey 5A steps of smoking cessation practice (Ask, Advise, Assess, Assist and Arrange) were provided to primary care physicians (PCPhs) and nurses (PCNs).

Respondents included 1182 PCPhs and 1063 PCNs. The proportions of current and former smokers were significantly higher among PCPhs than among PCNs (34.4 vs. 30.7 % and 14.0 vs. 10.1 %, respectively; both P < 0.001). We observed that 77.2 % of PCPhs and 58.4 % of PCNs always or rarely practiced an “Ask” step about their patients’ smoking status (P < 0.001). One-third of PCPhs (33.8 %) stated that they always practiced an “Ask” step, whereas only 27.6 % of PCNs always did so in their practice (P < 0.001). A small minority of primary care providers had advised patients to quit smoking, although there was a significant difference in this between PCNs and PCPhs (8.4 vs. 15.6 %; P < 0.001). Most PCPhs considered themselves competent in advising about smoking interventions, but only a minority of PCNs did so (75.1 vs. 17.3 %; P < 0.001). Among barriers to tobacco intervention measures, lack of time was the item most commonly cited by PCPhs, whereas low patient priority was most commonly cited by PCNs (35.9 and 35.7 %; P < 0.001).

Smoking intervention practice by primary care nurses was quite low. Lack of time and low patient priority were identified as barriers by primary care providers. Strategies by which primary care providers could improve tobacco control should be established.

Sarna L, Bialous SA, Sinha K, Yang Q, Wewers ME. Are health care providers still smoking? Data from the 2003 and 2006/2007 Tobacco Use Supplement-Current Population Surveys. Nicotine Tob Res. 2010;12:1167–71.
Pelkonen M. Smoking: relationship to chronic bronchitis, chronic obstructive pulmonary disease and mortality. Curr Opin Pulm Med. 2008;14:105–9.
Zwar NRR, Borland R, Stillman S, Cunningham M, Litt J. Smoking cessation guidelines for Australian general practice. Aust Fam Physician. 2005;34:461–6.
Vogt F, Hall S, Marteau TM. General practitioners’ and family physicians’ negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review. Addiction. 2005;100:1423–31.
Zwar NA, Zwar NA, Richmond RL, Zwar NA, Richmond RL. Role of the general practitioner in smoking cessation. Drug Alcohol Rev. 2006;25:21–6.
Pipe A, Sorensen M, Reid R. Physician smoking status, attitudes toward smoking, and cessation advice to patients: an international survey. Patient Educ Couns. 2009;74:118–23.
Bener A, Gomes J, Anderson JA, Abdullah S. Smoking among health professionals. Med Educ. 1994;28:151–7.
De Col PBC, Guillaumin C, Bouquet E, Fanello S. Influence of smoking among family physicians on their practice of giving minimal smoking cessation advice in 2008. A survey of 332 general practitioners in Maine-et-Loire. Rev Mal Respir. 2010;27:431–40.
9. WHO Report on the Global Tobacco Epidemic 2013. Date of Access: September, 2013.
Ministry of Health. National Tobacco Control Program and Action Plan of Turkey, 2008–2012, 2008.
Erguder TCB, Aslan D, Warren CW, Jones NR, Asma S. Evaluation of the use of Global Youth Tobacco Survey (GAYS) data for developing evidence-based tobacco control policies in Turkey. BMC Public Health. 2008;8:S4.
Baltaci D, Bahcebasi T, Aydin LY, Ozturk S, Set T, Eroz R, et al. Evaluation of smoking habits among Turkish family physicians. Toxicol Ind Health. 2014;30:3–11.
Tong EK, Strouse R, Hall J, Kovac M, Schroeder SA. National survey of U.S. health professionals' smoking prevalence, cessation practices, and beliefs. Nicotine Tob Res. 2010;12:724–33.
Stamatopoulou E, Stamatiou K, Voulioti S, Christopoulos G, Pantza E, Stamatopoulou A, et al. Smoking behavior among nurses in rural Greece. Workplace Health Saf. 2014;62:132–4.
Hodgetts G, Broers T, Godwin M. Smoking behaviour, knowledge and attitudes among Family Medicine physicians and nurses in Bosnia and Herzegovina. BMC Fam Pract. 2004;5:12.
Pizzo AM, Chellini E, Grazzini G, Cardone A, Badellino F. Italian general practitioners and smoking cessation strategies. Tumori. 2003;89:250–4.
Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28:169–80.
Khattab A, Javaid A, Iraqi G, Alzaabi A, Kheder AB, Koniski M-L, et al. Smoking habits in the Middle East and North Africa: Results of the BREATHE study. Respir Med. 2012;106:S16–24.
Bernat DH, Klein EG, Forster JL. Smoking initiation during young adulthood: a longitudinal study of a population-based cohort. J Adolesc Health. 2012;51:497–502.
Freedman KS, Nelson NM, Feldman LL. Smoking initiation among young adults in the United States and Canada, 1998–2010: A systematic review. Prev Chronic Dis. 2012;9, E05.
Vangeli E, Stapleton J, Smit ES, Borland R, West R. Predictors of attempts to stop smoking and their success in adult general population samples: a systematic review. Addiction. 2011;106:2110–21.
Tsoh JY, Tong EK, Gildengorin G, Nguyen TT, Modayil MV, Wong C, et al. Individual and family factors associated with intention to quit among male Vietnamese American smokers: implications for intervention development. Addict Behav. 2011;36:294–301.
Smit ES, Fidler JA, West R. The role of desire, duty and intention in predicting attempts to quit smoking. Addiction. 2011;106:844–51.
WHO. The Role of Health Professionals in Tobacco Control. Geneva: WHO; 2005.
Sarna LP, Brown JK, Lillington L, Rose M, Wewers ME, Brecht ML. Tobacco interventions by oncology nurses in clinical practice. Cancer. 2000;89:881–9.
Sabra AA. Smoking attitudes, behaviours and risk perceptions among primary health care personnel in urban family medicine centers in Alexandria. J Egypt Public Health Assoc. 2007;82:43–64.
Eldein HN, Mansour NM, Mohamed SF. Knowledge, attitude and practice of family physicians regarding smoking cessation counseling in family practice centers, Suez Canal University, Egypt. J Fam Med Prim Care. 2013;2:159.
Smith PM, Sellick SM, Spadoni MM. Tobacco cessation Clinical Practice Guideline use by rural and urban hospital nurses: a pre-implementation needs assessment. BMC Nursing. 2012;11:6.
Panaitescu C, Moffat MA, Williams S, Pinnock H, Boros M, Oana CS, et al. Barriers to the provision of smoking cessation assistance: a qualitative study among Romanian family physicians. NPJ Primary Care Respiratory Medicine. 2014;24:14022.
Helgason ÁR, Lund KE. General practitioners' perceived barriers to smoking cessation-results from four Nordic countries. Scand J Public Health. 2002;30:141–7.
Block DE, Hutton KH, Johnson KM. Differences in tobacco assessment and intervention practices: a regional snapshot. Prev Med. 2000;30:282–7.
32. Yearly Health Statistics 2012. Accessed in September 2014.
Turker Y, Aydin LY, Baltaci D, Erdem O, Tanriverdi MH, Sarigüzel Y, et al. Evaluation of post-graduate training effect on smoking cessation practice and attitudes of family physicians towards tobacco control. Int J Clin Exp. 2014;7:2763.
Aydin LY, Baltaci D, Ozturk S, Saritas A, Eroz R, Celepkolu T, et al. Smoking habits of nurses and midwives and their attitudes tobacco control; a primary care based study from four major cities of Turkey. Healthmed. 2012;6:3920–8.
Tobacco Cessation Interventions in Tertiary Hospitals in Nigeria: An Audit of Patient Records
Oluwakemi Odukoya, Mustapha Jamda, Olanrewaju Onigbogi, Nkolika Uguru, Modupe Onigbogi, Funmilola James, Babalola Faseru, Scott Leischow, Olalekan Ayo-yusuf
Nicotine & Tobacco Research
Behavioral Medicine and Integrated Care
Claire C. Conley, Marlena M. Ryba, Barbara L. Andersen
Do smoking assess in psychiatric outpatients?
Hülya Ertekin, Memduha Aydın, Mehmet Arslan, Yusuf Ertekin, İbrahim Eren
Konuralp Tıp Dergisi
Attitudes towards anti-smoking legislation and prevalence of tobacco consumption in Spanish primary healthcare personnel
Sanmartín Iglesias, Martinez Furio, Jiménez Clemente, Cohen Barchilon, Cesar Minué-Lorenzo, Osca Ribera, Perez-Teijon Cascon, Garcia Cordoba, Fernandez Lozano, Domenech Gallardo, Chaves Salguero, Navascues Mendiguren, Maria Rodriguez, Rubio Güeto, Rayo Morena, Otero Marioni, Lopez Gorreto, Guillem Camarelles, Fuente Martin, Ruiz Beni, Rodríguez Hernández, Dios De, Carlos Martin-Cantera
Tobacco Prevention & Cessation
Assessment of the Relationship between Dependency Scores and Carbon Monoxide Levels in Expiratory Air of Smokers
Cemil Sönmez, Tuğba Aktaş, Usame Velioğlu, Duygu Başer
Aile Hekimliği ve Palyatif Bakım
Prevalence of smoking in nursing professionals of a cardiovascular hospital
Andrea Ayoub, Márcio Sousa
Revista Brasileira de Enfermagem
Mustafa ÜNAL, Mustafa Ünal
Konuralp Tıp Dergisi
Estudio de corte transversal sobre el estado de conocimientos, actitudes y prácticas de médicos colombianos ante el tabaquismo
Claudia Robayo-González, Juan Uribe-Caputi
Variation in Patient Smoking Cessation Rates Among Health-Care Providers
Saja Almaaitah, Elizabeth Ciemins, Vaishali Joshi, Anupama Arora, Christopher Meskow, Michael Rothberg
Prácticas, barreras y facilitadores de proveedores de salud en clínicas para dejar de fumar en México
Rosibel Rodríguez-Bolaños, Guadalupe Ponciano-Rodríguez, Anabel Rojas-Carmona, Francisco Cartujano-Barrera, Evelyn Arana-Chicas, Ana Cupertino, Luz Reynales-Shigematsu
Enfermería Clínica
Practice, barriers, and facilitators of healthcare providers in smoking cessation in Mexico
Rosibel Rodríguez-Bolaños, Guadalupe Ponciano-Rodríguez, Anabel Rojas-Carmona, Francisco Cartujano-Barrera, Evelyn Arana-Chicas, Ana Cupertino, Luz Reynales-Shigematsu
Enfermería Clínica (English Edition)
Nurses' perspectives regarding integrated nursing interventions for psychoactive substance use cessation: A mixed methods study from South India
Sugavanaselvi K., Prasanthi Nattala, A. B., Pratima Murthy
Perspectives in Psychiatric Care
A Comparison of Haitian and American Bachelor of Science in Nursing Students' Perceptions of Cigarette Smoking and E-Cigarette Use
Larider Ruffin, Mary Padden-Denmead, Jack Lewis, Tavonia Ekwegh, Shawn Denning, Trevor Calimer, Tara Crowell
Journal of Addictions Nursing
Knowledge of health-care professionals on tobacco cessation and its related activities
Neetu Kataria, Sandhya Gupta
Current Medicine Research and Practice
The relationship between smoking status and smoking cessation practice for health workers in Surabaya
Kurnia Artanti, Santi Martini, Mahmudah Mahmudah, Sri Widati, Diva Adila, Muhammad Rahman
Journal of Public Health in Africa
Journals System - logo
Scroll to top