Navy health care provider attitudes and practices concerning patient tobacco use.

This study surveyed 2,287 U.S. Navy health care providers (HCPs) regarding patient-care practices and attitudes related to tobacco use. Almost 80% of HCPs reported that they usually asked new patients about tobacco use. Of 11 recommended practices, two-thirds to three-quarters of HCPs engaged in only 4 behaviors with most or all of their tobacco-using patients: advise patients to stop, advise pregnant users of health risks to the fetus, inform patients of benefits of quitting, and explain dangers of using tobacco. Other recommended cessation strategies were not performed regularly (e.g., assist patients in setting quit date, develop cessation plan, provide self-help materials, make referrals to cessation programs, prescribe nicotine gum, or arrange follow-up visits). It is recommended that concerted efforts he made to train all military HCPs (e.g., physicians, dentists, nurse practitioners, and physician assistants) to use the National Cancer Institute's "Four A's" approach for patient tobacco cessation, and that strong organizational support to implement these procedures be provided.