Home > Factors influencing European GPs' engagement in smoking cessation: a multi-country literature review.

the PESCE European Research Team. Stead, Martine and Cohen, David and Tait, Gayle (2009) Factors influencing European GPs' engagement in smoking cessation: a multi-country literature review. British Journal of General Practice, 59, (566), pp. 682-690. doi: 10.3399/bjgp09X454007.

External website: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC273435...

Background: Smoking cessation advice by GPs is an effective and cost-effective intervention, but is not implemented as widely as it could be.

Aim: This wide-ranging Europe-wide literature review, part of the European Union (EU) PESCE (General Practitioners and the Economics of Smoking Cessation in Europe) project, explored the extent of GPs' engagement in smoking cessation and the factors that influence their engagement.

Method: Two searches were conducted, one for grey literature, across all European countries, and one for academic studies. Data from eligible studies published from 1990 onwards were synthesised and reported under four categories of influencing factors: GP characteristics, patient characteristics, structural factors, and cessation-specific knowledge and skills.

Results: The literature showed that most GPs in Europe question the smoking status of all new patients but fewer routinely ask this of regular patients, or advise smokers to quit. The proportion offering intensive interventions or prescribing treatments is lower still. Factors influencing GPs' engagement in smoking cessation include GPs' own smoking status and their attitudes towards giving smoking cessation advice; whether patients present with smoking-related symptoms, are pregnant, or heavy smokers; time, training, and reimbursement are important structural factors; and some GPs lack knowledge and skills regarding the use of specific cessation methods and treatments, or have limited awareness of specialist cessation services. No single factor or category of factors explains the variations in GPs' engagement in smoking cessation.

Conclusion: Strategies to improve the frequency and quality of GPs' engagement in smoking cessation need to address the multifaceted influences on GPs' practice and to reflect the widely differing contexts across Europe.

Item Type
Publication Type
International, Open Access, Article
Drug Type
Tobacco / Nicotine
Intervention Type
Harm reduction
Identification #
doi: 10.3399/bjgp09X454007
Page Range
pp. 682-690
Royal College of General Practitioners
Corporate Creators
the PESCE European Research Team
Accession Number
HRB (Electronic Only)

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