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Encouraging conversations about quitting smoking between patients and doctors

Behaviourally informed tools that make a difference

Blog 5th Feb 2025

Every year, more than 75,000 deaths in France are caused by smoking. Research shows that support from a doctor significantly increases the chances of quitting, but many of these critical conversations never happen 4. A 2021 study by Santé Publique France and the Institut National du Cancer revealed that only 22.5% of smokers had discussed the issue of smoking with a healthcare professional in the last 12 months. So, how can we encourage healthcare professionals to start these vital conversations – and help more smokers succeed in quitting?

This is the challenge that BIT and Santé publique France tackled by designing and evaluating a behaviourally-informed intervention—leading to a 13% increase in conversations between GPs and patients about quitting smoking.

Breaking barriers to better conversations

We identified key obstacles preventing GPs from discussing smoking cessation: lack of time, misconceptions about  patients’ motivations and underestimating the importance of their role in helping patients quit smoking. On the patient side, negative attitudes towards support from healthcare professionals, a low sense of self-efficacy, and a perceived personal responsibility, often discourage them from seeking help.

To address these challenges , we co-designed three practical tools in collabartaion with teams from Santé publique France, doctors and smokers:

  • A questionnaire for patients to share their smoking status and motivation to quit, distributed in the waiting room or by reception staff.
  • A structured advice sheet to help doctors guide effective conversations.
  • A poster to promote the questionnaire and encourage open discussions about smoking between doctors and patients.

What we found

The impact of these tools was assessed using a randomised controlled trial (RCT) involving 641 GPs. The results of the trial showed that after one month :

  • The number of discussions about smoking cessation increased by 13%—equating to an average of 2.5 additional conversations per week for doctors who used the tools.
  • Doctors in the intervention group were more likely to assess their patients’ level of motivation and dependence, which helped them tailor their advice more effectively.
  • Increased follow-up support, with 74% of doctors in the intervention group offering follow-up consultations (compared to 60% in the control group).

The evaluation, which included a qualitative study of around ten doctors, also identified areas for improvement. For example, distributing questionnaires passively (in waiting rooms) was less effective compared to when medical staff handed them directly to patients. Additionally, more prominent signage could make the tools more noticeable.

A scalable, evidence-based solution

This study shows how simple yet targeted tools can significantly enhance healthcare professionals’ efforts to support smoking cessation. While the individual impact may seem modest, scaling these tools could lead to major public health benefits by reducing smoking rates and associated healthcare costs.

Interested in our approach? Read more details about the study here, or contact us here to discuss further and explore opportunities for collaboration.

Pereira G, Pasquereau A, Andler R, Guignard R, Deutsch A, Nguyen Thanh V, et al. Tobacco and cancer: perception of risks in 2021 and changes since 2015. In: Baromètre cancer 2021 Attitudes et comportements des Français face au cancer. Boulogne Billancourt: Institut national du cancer and Santé publique France; 2023. pp. 78-107.

Tabac Info Service, 2021: https://www.tabac-info-service.fr/j-arrete-de-fumer/j-arrete-de-fumer-seul-ou-accompagne

 

Authors

Design and development by Soapbox.