Premium
Do doctors' smoking habits influence their smoking cessation practices? A systematic review and meta‐analysis
Author(s) -
Duaso Maria J.,
McDermott Máirtín S.,
Mujika Agurtzane,
Purssell Edward,
While Alison
Publication year - 2014
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12680
Subject(s) - medicine , smoking cessation , meta analysis , confidence interval , relative risk , demography , random effects model , systematic review , medline , pathology , sociology , political science , law
Aims To assess the association between doctors' smoking status and the use of the ‘5 A s’ of smoking cessation. Methods A systematic search of 11 databases covering E nglish and S panish language publications since 1996 was undertaken. Studies were included if they reported doctors' smoking status (current, former or never smoker) and rates of practising any of the 5 A s of smoking cessation ( A sk; A dvise; A ssess; A ssist; and A rrange). Frequencies and proportions were extracted from individual papers and risk ratios ( RR ) were calculated. A random‐effects meta‐analysis model was used to assess the effect of the doctor's personal smoking history. Covariate effects were explored using meta‐regression for three pre‐specified study characteristics: doctors' role, smoking prevalence of the sample and study quality. Results Twenty studies were included in this systematic review. The RR of always asking patients about their smoking was not associated significantly with doctors' smoking status [ RR = 0.98; 95% confidence interval ( CI ) = 0.94–1.02; P = 0.378; I 2 = 0.00%; 10 studies]. Meta‐analysis suggested that doctors who were current smokers had a 17% increased risk of not advising their patients to quit compared with never‐smokers ( RR = 0.83; 95% CI = 0.77–0.90; P < 0.000; I 2 = 82.14%; 14 studies). However, high levels of heterogeneity were found that were not explained by the meta‐regression. Regarding assisting patients to quit, never smokers were more likely to counsel than current smokers ( RR = 0.92; 95% CI = 0.85–0.99; P = 0.036; I 2 = 0.00%; three studies) but less likely to make a referral ( RR = 1.40; 95% CI = 1.09–1.79; P = 0.009; I 2 = 0.00%; five studies). No statistically significant differences were found in arranging future contact by smoking status ( RR = 0.80; 95% CI = 0.52–1.23; P = 0.315; I 2 = 47.03%; four studies). Conclusions Smoking status of doctors may affect their delivery of smoking cessation treatments to patients, with smokers being less likely than non‐smokers or ex‐smokers to advise and counsel their patients to quit but more likely to refer them to smoking cessation programmes.