• tobacco dependence treatment;
  • 5A's;
  • brief tobacco treatment;
  • survey;
  • Level of Evidence: NA


Although one in five U.S. adults continue to smoke, healthcare providers often fail to provide basic, effective interventions. This is particularly true for physician specialists. This study sought to investigate perceived role, self-efficacy, practice behaviors, and attitudes among otolaryngologists as they relate to the delivery of tobacco treatment services.

Study Design

This study involved a single administration of a survey questionnaire to current members of the American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS).


A questionnaire was mailed up to three times to active members.


Survey response rate was 39% (N = 2127). Based on an evaluation of treatment factors categorized according to the National Cancer Institute's 5A's approach, trained providers generally rated themselves consistently higher than untrained providers across areas of clinical activity. Minimal differences were noted for Ask and Advise, moderate for Assess, and the greatest for Assist and Arrange. Trained providers also indicated more positive attitudes towards treatment.


While the level of performance was reasonable for otolaryngologists relative to other specialists in the published literature, overall tobacco treatment activity remains unacceptably low. This study suggests the positive impact of training and the potential value of making such experiences widely available. Laryngoscope, 123:3005–3009, 2013