• Catherine Bolman, Carolien Sino, Paul Hekking, Anton van Keimpema, and Jan van Meerbeeck.
• Department of Psychology, Netherlands Open University, Heerlen, Valkenburgerweg 177, P.O. Box 2960, 6401 DL Heerlen, The Netherlands. catherine.bolman@ou.nl
• Patient Educ Couns. 2005 Apr 1; 57 (1): 126-33.

AbstractEffective smoking cessation interventions include steps often protocolised as the 4A method. This study assessed how pulmonologists address the smoking behaviour of chronic obstructive pulmonary disease (COPD) patients and analysed psychosocial differences between pulmonologists who intend to use the 4A method and those who do not intend to use it. A nationwide survey was conducted among Dutch pulmonologists (N = 320), of whom 63% responded. Pulmonologists routinely assessed patients' smoking behaviour and their willingness to quit, but were least experienced in actually assisting patients to quit. Pulmonologists intending to use the method perceived a more supportive social environment in working with it and were more convinced of their ability to use it. Overall, pulmonologists were not convinced that the method would result in more patients quitting, and were pessimistic about their ability to use it. Pulmonologists need to be convinced of the effectiveness of the 4A method and their ability to use it. Skills training and the creation of a social environment supportive toward smoking cessation assistance are recommended.

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