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How Prepared Are Psychiatry Residents for Treating Nicotine Dependence?

Received August 25, 2004; revised November 4, 2004; accepted November 11, 2004. Drs. Prochaska, Fromont, and Hall are all with the University of California San Francisco School of Medicine, Department of Psychiatry, San Francisco, California. Address correspondence to Dr. Prochaska, University of California San Francisco School of Medicine, Department of Psychiatry, 401 Parnassus Ave.-TRC 0984, San Francisco, CA 94143-0984; JProchaska{at}lppi.ucsf.edu (E-mail). Copyright © 2005 Academic Psychiatry.

OBJECTIVE: Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and a leading cause of death and disability. The authors examined the extent to which psychiatry residents are prepared to treat nicotine dependence in clinical practice. METHODS: Residents from five psychiatry residency programs in northern California completed an anonymous survey of their knowledge, attitudes, and behaviors regarding treating nicotine dependence among their patients. RESULTS: Respondents (N = 105, 60% female) represented all 4 years of residency training. Residents’ smoking status was 11% current, 17% former, and 72% never. Knowledge scores averaged 54% correct. Confidence ratings averaged 3 (SD = 0.6) on a 5-point scale. Seventy six percent rated their overall ability to help patients quit using tobacco as fair or poor. The percent reporting often or always engaging in the National Cancer Institute’s 5-A intervention for smoking cessation was: 58% ask; 29% advise; 17% assess; 18% assist; and 13% arrange follow up. Most residents reported none or inadequate tobacco cessation training during medical school (74%) or residency (79%), and nearly all (94%) reported moderate to high interest in learning more about helping patients quit smoking. CONCLUSION: Psychiatry residents appear unprepared to treat nicotine dependence, but report considerable interest in this area. The findings demonstrate the need for and interest in tobacco cessation curricula in psychiatry residency training.

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