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Activating Patients for Smoking Cessation Through Physician Autonomy Support

Bibliographic Data

ID9101208
AuthorsGeorge C Williams (0000-0003-2050-5658, University of Rochester, corresponding author), Geoffrey C Williams, Edward L Deci (0000-0001-8246-8536)
Year2001
Volume39
Issue8
Pages813-823
Publication date2001-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-200108000-00007
PMID11468500
OpenAlexW2322374758
LanguageEN
Citations received16
References cited21

OBJECTIVE: Test whether physicians' counseling patients for smoking cessation with an autonomy supportive rather than controlling style would increase patients' active involvement in the counseling session and increase maintained abstinence. DESIGN: Randomized trial of 27 community-based physicians using two interview styles, with observer ratings of patient active involvement and assessments of patient smoking status at 6 months, 12 months, and 30 months. PATIENTS: Adult smokers: 336 recruited; 249 for final analyses. INTERVENTION: Physicians used an autonomy- supportive or controlling interpersonal style, randomly assigned within physician, to briefly counsel patients about smoking cessation, using the National Cancer Institute's 4-A's model. MEASUREMENT: Patient active involvement was rated from audio tapes of the interviews. Continuous abstinence came from self-reports at 6 months, 12 months, and 30 months, CO validated at 6 months or 12 months and at 30 months. RESULTS: Physician style did not have a significant direct effect on smoking cessation but did significantly increase patient active involvement in the interview. Active involvement, in turn, increased smoking cessation. Structural equation modeling confirmed a theoretical model in which the intervention positively predicted patient active involvement after controlling for patient reports of wanting to stop smoking, and active involvement significantly predicted continuous abstinence after controlling for previous quit attempts. CONCLUSIONS: Although physicians' autonomy- supportive style while counseling smokers to quit did not have a direct effect on smoking cessation, it increased patients' active involvement in the counseling session which in turn increased continuous abstinence over 30 months. Further research should clarify the direct effects of physician interpersonal style on health outcomes

Abstinence · Autonomy · Family medicine · Interpersonal communication · Physical therapy · Psychiatry · Randomized controlled trial · Smoking cessation · Behavioral Health and Interventions · Clinical Psychology · Diabetes Management and Education · Internal Medicine · Medicine · Psychology · Smoking Behavior and Cessation · Social Psychology

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Unique citing works16
Citations per year0,73
Citation span2004 - 2026 (23)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 15

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