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dc.contributor.authorWheat, Hannah
dc.contributor.authorBarnes, R
dc.contributor.authorAveyard, P
dc.contributor.authorStevenson, F
dc.contributor.authorBegh, R
dc.date.accessioned2022-10-14T13:34:48Z
dc.date.issued2022-12
dc.identifier.issn1873-5347
dc.identifier.issn1873-5347
dc.identifier.other115463
dc.identifier.urihttp://hdl.handle.net/10026.1/19693
dc.description.abstract

Very brief opportunistic interventions for smoking cessation are effective, cost-saving for health systems, and universally recommended in guidelines. However, evidence suggests that clinicians are reluctant to intervene, citing interactional difficulties. Only one UK study has specifically examined smoking discussions, within naturally occurring primary care consultations. However smoking cessation treatment was not available at the time. We examined existing datasets amounting to 519 video-recordings of GP consultations in England for instances of talk about smoking. We used conversation analytic methods to assess patients' responses to doctors asking about smoking, giving advice on smoking, and offering cessation treatment. In 31 recordings it was apparent that the patient smoked, and, in 25/31 consultations, doctors initiated the topic of smoking. They did so by asking about smoking status, commonly during the history-taking phase of the consultation. In many instances, these questions led to active resistance from patients against being placed in a discreditable category, for example by minimising their smoking. This was more pronounced when GPs pursued efforts to quantify the amount smoked. Thereafter, where doctors returned to the topic of smoking, they did so typically by linking smoking to the patient's medical condition, which likewise led to resistance. Guidance recommends that GPs advise on how best to quit smoking where patients are interested in doing so, but this was only evident in a minority of consultations. Where GPs offered support for cessation, they did so using interactional practices that minimised the need for the patient to respond and thereby accept. Interactional difficulties were found to be common in consultations between GPs and people who smoke when GPs actions aligned with some VBA guidelines. Future research should examine when and how advice on how best to quit, and offers of support, should be delivered within primary care consultations.

dc.format.extent115463-115463
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoen
dc.publisherElsevier
dc.subjectConversation analysis
dc.subjectSmoking
dc.subjectPrimary care
dc.subjectVery brief advice (VBA) intervention
dc.titleBrief opportunistic interventions by general practitioners to promote smoking cessation: a conversation analytic study
dc.typejournal-article
dc.typeJournal Article
dc.typeResearch Support, Non-U.S. Gov't
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000903743700011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.volume314
plymouth.publication-statusPublished
plymouth.journalSocial Science and Medicine
dc.identifier.doi10.1016/j.socscimed.2022.115463
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/FoH - Community and Primary Care
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEngland
dcterms.dateAccepted2022-10-14
dc.rights.embargodate2022-11-11
dc.identifier.eissn1873-5347
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1016/j.socscimed.2022.115463
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review


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