Transforming Tobacco Cessation Counselling in Primary Care: A Mixed-Methods Evaluation of the Shared Decision-Making Model.

Background: Smoking cessation aids are under-prescribed in primary care. General practitioners (GPs) might prescribe more smoking cessation aids if they focused on the choice between treatments as the default, rather than using motivational interviewing that focuses on whether to make a quit attempt...

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Publicado en:Tobacco Use Insights Vol. 19; pp. 1 - 14
Autores principales: Habfast-Robertson, Ines, Boesch, Anne, Hempel-Bruder, Christina, Durand, Marie-Anne, Maisonneuve, Hubert, Amiguet, Michael, Berlin, Ivan, Selby, Kevin
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 8/10/2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 8/10/2026
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        atl: Transforming Tobacco Cessation Counselling in Primary Care: A Mixed-Methods Evaluation of the Shared Decision-Making Model.
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        au:
          Habfast-Robertson, Ines
          Boesch, Anne
          Hempel-Bruder, Christina
          Durand, Marie-Anne
          Maisonneuve, Hubert
          Amiguet, Michael
          Berlin, Ivan
          Selby, Kevin
        affil: University Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
      sug:
        subj:
          Physicians, Family Education
          Primary Health Care
          Counseling
          Smoking Cessation Programs Education
          Decision Making, Shared Evaluation
          Outcomes of Education Evaluation
          Human
          Male
          Female
          Adult
          Middle Age
          Questionnaires
          Self Report
          Logistic Regression
          Descriptive Statistics
          Interviews
          Confidence Intervals
          Odds Ratio
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: Smoking cessation aids are under-prescribed in primary care. General practitioners (GPs) might prescribe more smoking cessation aids if they focused on the choice between treatments as the default, rather than using motivational interviewing that focuses on whether to make a quit attempt. Objectives: Explore the self-reported adoption and impressions of shared-decision making (SDM) for smoking cessation treatments using a decision aid amongst GPs who received intervention or control trainings. Design: Mixed quantitative-qualitative convergent analysis of self-reported behaviours from GPs in a pragmatic, cluster-randomized trial conducted between 2021-2023 in Switzerland and France. Methods: The intervention training encouraged GPs to offer a choice of smoking cessation aids as the default choice using a decision aid (sustained intervention). The control training presented cessation aids without encouraging GPs to change how they discuss smoking cessation. Implementation was measured using questionnaires before and after the trainings, then at 6- and 12-month follow-up. Self-reported behaviours were quantitatively analysed using logistic regression adjusting for baseline responses. Experiences using SDM and default choice were explored through semi-structured interviews. Results: A total of 43 GPs completed questionnaires (26 women (60%), age range 30-59 years) and 12 an interview. The intervention group reported more sustained interventions (OR 8.2 (CI 1.9-50)), use of the decision aid (OR 19.7 (CI 4.1-135)), and offer of treatments as the default choice than the control group (OR 6.4 (CI 1.4-40)) at 12-month follow-up. Small sample size bias was addressed by using Firth's methodology. In interviews, GPs in the intervention group highlighted the utility of the decision aid and the importance of adapting the default approach to the context of individual patients. Conclusion: GPs in the intervention group reported more often initiating treatment discussions with patients who smoke using a decision aid, but not more prescriptions. The default approach was not appropriate for all patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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