BACKGROUND: General practice clinicians (GPs) in the UK are incentivised to record patients’ smoking status, particularly those with conditions like coronary heart disease and serious mental illnesses. While evidence-based support from healthcare professionals significantly increases smoking cessation rates, intervention rates by GPs are low. Smoking is a dependency requiring treatment, but perceptions of it as a personal choice and concerns about patient motivation can deter clinicians from offering support. This study explores the attitudes of GPs and medical students towards smoking and the impact of morally framed messages on the likelihood of their providing smoking cessation support.
METHODS: A between-subjects online experimental study was conducted in May 2023 with 300 UK-based GPs and medical students. Participants were randomly assigned to one of three message-framing conditions: professional obligation; shared responsibility; or a neutral control. They rated their desire, sense of duty, and intention to provide smoking cessation support in hypothetical scenarios, as well as their agreement with health-related statements on smoking attitudes.
RESULTS: Sixty-four percent of participants were female, 91% had never smoked, and 7% lived with someone who currently smoked. Professional obligation framing elicited the highest intention to provide smoking cessation support. While 70% viewed smoking as a lifestyle choice, 88% agreed that addiction is a disease requiring treatment. Seventy-two percent believed individuals with unhealthy lifestyles should make greater efforts to change, and 81% agreed doctors have a duty to help regardless of patient motivation.
CONCLUSIONS: Responsibility-framed messages, particularly those emphasising professional obligation, may strengthen healthcare professionals’ intentions to deliver smoking cessation support. However, the attitudinal divide between perceiving smoking as a lifestyle choice and as an addiction underscores the need for targeted education. Policies addressing misconceptions and fostering adherence to evidence-based guidelines could bridge this gap, ultimately enhancing intervention rates and patient outcomes.