Are light smokers less likely to receive advice to quit from their GP than moderate-to-heavy smokers? A comparison of population data from the Netherlands and England.

Abstract presented at the 14th Annual Meeting of the Society for Research on Nicotine and Tobacco (SRNT) Europe held in Helsinki, Finland on 2 September 2012


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Kotz, Daniel* [1,2]

Willemsen, Marc C. [3,4]

West, Robert [2]

[1]Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands. [2]Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK. [3]Dutch Expertise Centre on Tobacco Control, STIVORO, The Hague, the Netherlands. [4]Department of Health Promotion, CAPHRI, Maastricht, The Netherlands. *Presenting author.




About one third of current smokers in the Netherlands and in England smoke less than 10 cigarettes per day (cpd). The aim of the current study was to assess whether light smokers (<10cpd) are less likely to receive advice to stop smoking during a consultation with their GP than moderate-to-heavy smokers (>=10cpd), and whether the level of GP advice differs between countries.



Comparison of data from two series of monthly national surveys: the Dutch “Continuous Survey of Smoking Habits” and the English “Smoking Toolkit Study”. We used data from respondents to both surveys in the period from February 2010 through to December 2011 who were 16+ years of age and consulted their GP in the previous 12 months.



A total of 7,734 smokers responded to the surveys in the Netherlands and 10,383 in England. The percentage Dutch smokers receiving advice to quit from their GP was 22.6% (95%CI=21.5-23.7) compared to 58.9% (95%CI=57.6-60.2) of English smokers. Light smokers were less likely to receive advice to quit from their GP than moderate-to-heavy smokers, and this difference was larger in the Netherlands (OR=0.57, 95%CI=0.50-0.65) than in England (OR=0.64, 95%CI=0.57-0.72). The percentage light smokers who received a recommendation/prescription for smoking cessation medication from their GP was similar in the Netherlands and in England: 20.9% (95%CI=16.4-25.3) and 23.6% (95%CI=22.2-24.9), respectively. However, the percentage light smokers who were referred to counselling was only one tenth in the Netherlands compared to England: 3.7% (95%CI=1.7-5.8) and 42.7% (95%CI=41.1-44.3), respectively.



Light smokers are less likely to receive advice to stop smoking from their GP than moderate-to-heavy smokers. Compared to England, smokers in the Netherlands are much less likely to receive advice to stop from their GP and a referral for smoking cessation counselling. These discrepancies may be explained by differences between countries in incentivisation of GPs for registration of smoking and offer of advice, available treatment infrastructure for referral to counselling, reimbursement of smoking cessation treatment, and culture.



The “Dutch Continuous Survey of Smoking Habits” is supported by grants from the Dutch Ministry of Health, Welfare and Sport. The “Smoking Toolkit Study” is funded by the English Department of Health, Cancer Research UK, Pfizer, GlaxoSmithKline, and Johnson and Johnson. Pfizer, Johnson and Johnson, and GlaxoSmithKline are manufacturers of smoking cessation products who had no involvement in the design of the study, collection, analysis or interpretation of the data, the writing of the report, or the decision to submit the paper for publication.


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