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Postgraduate education for doctors in smoking cessation


Nicholas A. Zwar MBBS PhD, FRACGP, Professor of General Practice, Robyn L. Richmond MA, MHEd, PhD, Professor of Public Health, David Davidson BSc, MDCM, CCFP(EM), FCFP, Assistant Professor, Iqbal Hasan MBBS, MPH, Project Officer. Professor Nicholas A. Zwar, School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia. Tel: +61 2 9385 2515; Fax: +61 2 9313 6185; E-mail:


Introduction and Aims. Smoking cessation advice from doctors helps improve quit rates but the opportunity to provide this advice is often missed. Postgraduate education is one strategy to improve the amount and quality of cessation support provided. This paper describes a sample of postgraduate education programs for doctors in smoking cessation and suggests future directions to improve reach and quality. Design and Methods. Survey of key informants identified through tobacco control listserves supplemented by a review of the published literature on education programs since 2000. Programs and publications from Europe were not included as these are covered in another paper in this Special Issue. Results. Responses were received from only 21 key informants from eight countries. Two further training programs were identified from the literature review. The following components were present in the majority of programs: 5 As (Ask, Advise, Assess, Assist and Arrange) approach (72%), stage of change (64%), motivational interviewing (72%), pharmacotherapies (84%). Reference to clinical practice guidelines was very common (84%). The most common model of delivery of training was face to face. Lack of interest from doctors and lack of funding were identified as the main barriers to uptake and sustainability of training programs. Discussion and Conclusions. Identifying programs proved difficult and only a limited number were identified by the methods used. There was a high level of consistency in program content and a strong link to clinical practice guidelines. Key informants identified limited reach into the medical profession as an important issue. New approaches are needed to expand the availability and uptake of postgraduate education in smoking cessation.[Zwar NA, Richmond RL, Davidson D, Hasan I. Postgraduate education for doctors in smoking cessation. Drug Alcohol Rev 2009;28:466–473]