Effect of healthcare practitioners´ advice on the decision to quit. GATS analysis from Argentina

Abstract

Background: Physicians have been paramount to lead the change in tobacco consumption worldwide. Healthcare team's advice on quitting has shown a small-sized but relevant effect. Argentine physicians have been found to smoke like the general population and adhere poorly to smoke-free rules in hospitals. The evidencebased National Guideline for Tobacco Cessation recommends doctors and nurses to give a short and strong advice to stop smoking. This study aimed to measure the quitting advice effect in real-life on the decision to do it. Method(s): Secondary analysis from the Global Adult Tobacco Survey (GATS) done in Argentina in 2012, restricted to adult smokers of 18 years old or more. Results from a populationbased study were analyzed using multivariable logistic regression modelling for the association of healthcare advice and a favorable attitude towards quitting (referring one quit attempt during last year, quitted less than a year ago or reported intention of quitting during the next month or year). Result(s): Our sample included 1,717 smokers and recent quitters representing 6,431,623 (mean age 40.21 years, 37.77% women). Favorable attitude was present in 26.15% 95%CI 20.53-32.67 (mean age 41.41 years, 35.86% females). During the last year, 46.82% consulted the healthcare system (51.06% females). Smoking status were asked in 80.29% of cases and 76.51% received advice. Most of them referred 1 to 2 visits (59.58%), 18.81% 3 to 5 visits and 21.58% 6 or more times. Multivariate analysis showed medical advice was strongly associated with a favorable attitude towards smoking cessation (OR 6.25 CI 95% 2.91-13.42) after adjusting by age, gender, educational level and income. Conclusion(s): In Argentina, healthcare practitioner's advice is strongly effective for promoting favorable attitude to quit regardless of age, gender, educational level and income. Advice was not systematically offered even after frequent visits. Additional strategies should be implemented to increase its delivery.