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In the 20 June 1998 issue of the “BMJ”, Butler et al published a study “to determine the effectiveness and acceptability of general practitioners’ opportunistic antismoking interventions by examining detailed accounts of smokers’ experiences of these.” Based on interviews with 42 current smokers and recent quitters, these investigators, from the University of Wales College of Medicine, concluded that “Doctor–patient relationships can be damaged if doctors routinely advise all smokers to quit.” The abstract from their article is reproduced in the box.
Because the conclusions reached by Butler et alchallenge the conventional wisdom espoused in the tobacco control community, we solicited commentaries on their paper from several experts in the role of physicians in smoking cessation. Two commentaries—one by Solberg and Kottke, and the other by Fiore and colleagues—appear below. Another reply to the article by Butleret al—from Hong Kong—appeared in the 5 December 1998 issue of the “BMJ” (1998; 317:1588).—ED
BMJ 1998;316 :1878–81 (20 June)
Qualitative study of patients’ perceptions of doctors’ advice to quit smoking: implications for opportunistic health promotion
Christopher C Butler,lecturer; Roisin Pill, professor; Nigel C H Stott, professor;
Department of General Practice, University of Wales College of Medicine, Cardiff CF3 7PN, UK
Objectives—To determine the effectiveness and acceptability of general practitioners’ opportunistic antismoking interventions by examining detailed accounts of smokers’ experiences of these.
Design—Qualitative semistructured interview study.
Subjects—42 participants in the Welsh smoking intervention study were asked about initial smoking, attempts to quit, thoughts about future smoking, past experiences with the health services, and the most appropriate way for health services to help them and other smokers.
Results—Main emerging themes were that subjects already made their own evaluations about smoking, did not believe doctors’ words could …
Dr LI Solberg, HealthPartners Research Foundation, 8100 34th Avenue South, PO Box 1309, Minneapolis, Minnesota 55440-1309, USA;
Dr MC Fiore, Center for Tobacco Research and Intervention, University of Wisconsin, Madison, Wisconsin 53706, USA;