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Patients welcome discussions with their doctors about smoking and other behaviors that affect their health

Half of all deaths in the United States are due to destructive health behaviors, such as smoking and overeating, and about 1.3 million people each year die from conditions that could have been prevented or delayed by healthier habits. Nevertheless, fewer than half of smokers are advised to quit by their doctors.

According to a recent study, patients welcome counseling about smoking cessation from their family physician and are more satisfied with doctors who provide this counseling. Furthermore, they are not put off when doctors discuss diet, exercise, alcohol and drug use, and prevention of sexually transmitted diseases, says a study supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00059).

These findings should reinforce physicians' confidence in discussing health habits with patients, conclude David A. Barzilai, B.A., B.S., of Case Western Reserve University, and his colleagues. In their study, research nurses observed health habit counseling during 2,459 adult outpatient visits to 138 community-based family physicians in Ohio. The researchers assessed patient satisfaction using a visit exit questionnaire. Physicians and patients were told only that the study was examining the content of family practice.

One or more behavioral issues were discussed during 48 percent of visits. Topics ranged from diet and exercise to tobacco and alcohol history and counseling, contraception and condom use, and prevention of sexually transmitted diseases. However, after adjustment for patient mix, only discussion of tobacco use and counseling about quitting smoking were significantly associated with patient satisfaction with their physician. Patients counseled about smoking (which can take as little as 3 minutes to be effective) were more likely to be very satisfied with their physician than those who were not counseled. Whether physicians advised patients about other health-related behaviors did not significantly affect how satisfied patients were with their doctors.

See "Does health habit counseling affect patient satisfaction?" by Mr. Barzilai, Meredith A. Goodwin, M.S., Stephen J. Zyzanski, Ph.D., and Kurt C. Stange, M.D., Ph.D., in Preventive Medicine 33, pp. 595-599, 2001.

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