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Tobacco use assessment and counselling practices among Alabama primary care physicians

Background Although national clinical practice guidelines exist for treatment of tobacco use, little is known about the extent to which they are used in daily practice.Methods Nine hundred Alabama family physicians and internists were surveyed to measure self-reported knowledge and use of guideline elements as well as past participation and future interest in continuing medical education (CME).Results Of 215 physicians responding (24%), 67% reported they routinely ask patients about tobacco use. Most (81%) advise quitting, but less than half (45%) assess willingness to quit or assist with quit attempts, and fewer (41%) arrange follow-up. One in four (25%) had previously participated in CME; one in five (22%) were familiar with the guideline; four out of five (81%) were interested in CME on the subject.Conclusions Analysis revealed a correlation between experiencing CME and utilisation of guideline elements. In response, a CME programme and PDA-based protocol were developed to facilitate integration of the recommended 5-A intervention into daily practice.


Myra A Crawford, Lesa L Woodby, Toya V Russell, Tamela J Turner, J Michael Hardin, T Michael Harrington

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