REVIEW © 2005 Society for the Study of Addiction doi:10.1111/j.1360-0443.2005.01221.x Addiction, 100, 1423–1431 Blackwell Science, LtdOxford, UKADDAddiction0965-2140© 2005 Society for the Study of Addiction 100 Original Article Physicians’ beliefs discussing smoking Florian Vogt et al. Correspondence to: Theresa M. Marteau Institute of Psychiatry Department of Psychology (at Guy’s) Health Psychology Section King’s College London 5th Floor Thomas Guy House London SE1 9RT UK Tel: 020 71882590 Fax: 020 71880195 E-mail: theresa.marteau@kcl.ac.uk Submitted 5 January 2005; initial review completed 16 March 2005; final version accepted 9 May 2005 REVIEW General practitioners’ and family physicians’ negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review Florian Vogt, Sue Hall & Theresa M. Marteau Institute of Psychiatry, Department of Psychology (at Guy’s), Health Psychology Section, King’s College London, London, UK ABSTRACT Objective To estimate the proportion of general practitioners (GPs) and family physicians (FPs) with negative beliefs and attitudes towards discussing smoking cessation with patients. Methods A systematic review. Study selection All studies published in English, in peer-reviewed journals, which allowed the extraction of the proportion of GPs and FPs with negative beliefs and attitudes towards discussing smoking cessation. Data synthesis Negative beliefs and attitudes were extracted and categorised. Proportions were synthesized giving greater weight to those obtained from studies with larger samples. Those assessed in two or more studies are reported. Results Across 19 studies, eight negative beliefs and attitudes were identified. While the majority of GPs and FPs do not have negative beliefs and attitudes towards discussing smoking with their patients, a sizeable minority do. The most common negative beliefs were that such discussions were too time- consuming (weighted proportion: 42%) and were ineffective (38%). Just over a quarter (22%) of physicians reported lacking confidence in their ability to dis- cuss smoking with their patients, 18% felt such discussions were unpleasant, 16% lacked confidence in their knowledge, and relatively few considered dis- cussing smoking outside of their professional duty (5%), or that this intruded upon patients’ privacy (5%), or that such discussion were inappropriate (3%). Conclusions In addition to providing skills training, interventions designed to increase the implementation of smoking cessation interventions by primary care physicians may be more effective if they address a range of commonly held negative beliefs and attitudes towards discussing smoking cessation. These include beliefs and values that influence primary care physicians’ judgements about whether discussing smoking is an effective use of their time. KEYWORDS Attitudes, beliefs, primary care physicians, review, smoking cessation. INTRODUCTION Tobacco is the world’s most dangerous product, killing more people than AIDS, legal and illegal drugs, road acci- dents, murder and suicide combined [1]. Primary care physicians can contribute to reducing the prevalence of smoking in the general population by brief smoking cessation interventions [2]. Such interventions comprise a number of strategies including asking patients whether they smoke, advising any that do so to stop, assessing motivation to stop, assisting motivated smokers in their attempts to stop and arranging follow-up appointments (the ‘five As’) [3,4]. Assistance includes recommending and prescribing such cost-effective interventions as