Clinical Leadership and Asymmetric Information: The Impact of Physician Advice on Smoking Cessation

DOI: 10.4236/ojl.2014.32002   PDF   HTML     2,566 Downloads   3,426 Views  


A knowledge gradient exists between experts in a given field and consumers of that knowledge. When the need arises, not knowing the best path, an average individual typically relies on the advice of an expert. Given the steep knowledge gradient between patient and provider, clinicians play an essential role in the clinical setting, acting as both a health leader and a health facilitator; however, this asymmetric information implies that clinical providers face an acute pressure not only to advise but to advise correctly. This paper explores the importance of physician advice within the context of smoking cessation, addressing two specific research questions: (1) among current smokers, do patients have a higher probability of any quit attempts in the last twelve months if a physician advised them to quit over the same period? and, (2) among current smokers who were advised to quit, do patients have a higher probability of any quit attempts in the past twelve months based, at least in part, on the specific quitting strategy suggested by the physician? The results suggest that physicians play a crucial role in promoting smoking cessation efforts. The findings further highlight a significant association between the advised cessation strategy and any quit attempts, although the direction of this relationship varies by the cessation strategy suggested.

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Keeler, C. (2014). Clinical Leadership and Asymmetric Information: The Impact of Physician Advice on Smoking Cessation. Open Journal of Leadership, 3, 7-19. doi: 10.4236/ojl.2014.32002.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Centers for Disease Control and Prevention (CDC) (2013). Tobacco Use Goals and Key Areas. Smoking & Tobacco Use. /index.htminformation/healthy_people/goals/index.htm
[2] Centers for Disease Control and Prevention (CDC) (2014). Current Cigarette Smoking Among Adults—United States, 2005-2012. Morbidity and Mortality Weekly Report (MMWR), 60, 29-34.
[3] Chang, F. C., Sung, H. Y., Zhu, S. H., & Chiou, S. T. (2014). Impact of the 2009 Taiwan Tobacco Hazards Prevention Act on Smoking Cessation. Addiction, 109, 140-146.
[4] Cohen, S. S., Sonderman, J. S., Mumma, M. T., Signorello, L. B., & Blot, W. J. (2011). Individual and Neighborhood-Level Socioeconomic Characteristics in Relation to Smoking Prevalence among Black and White Adults in the Southeastern United States: A Cross-Sectional Study. BMC Public Health, 11, 877.
[5] Fiore, M. C., Novotny, T. E., Pierce, J. P., Giovino, G. A., Hatziandreu, E. J., Newcomb, P. A., & Davis, R. M. (1990). Methods Used to Quit Smoking in the United States: Do Cessation Programs Help? Jama, 263, 2760-2765.
[6] Food and Drug Administration (FDA) (2013). Overview of the Family Smoking Prevention and Tobacco Control Act: Consumer Fact Sheet.
[7] Gilpin, E. A., & Pierce, J. P. (2002). Demographic Differences in Patterns in the Incidence of Smoking Cessation: United States 1950-1990. Annals of Epidemiology, 12, 141-150.
[8] Keeler, C. (2013). Liberation Health and the Role of the Public Health Leader. Open Journal of Leadership, 2, 82.
[9] Keeler, T. E., Marciniak, M., & Hu, T. W. (1999). Rational Addiction and Smoking Cessation: An Empirical Study. The Journal of Socio-Economics, 28, 633-643.
[10] Jemal, A., Thun, M., Xue, Q. Y., Hartman, A. M., Cokkinides, V., Center, M. M., & Ward, E. M. (2011). Changes in Smoking Prevalence among US Adults by State and Region: Estimates from the Tobacco Use Supplement to the Current Population Survey, 1992-2007. BMC Public Health, 11, 512.
[11] Mundinger, M. O., Kane, R. L., Lenz, E. R., Totten, A. M., Tsai, W. Y., Cleary, P. D., & Shelanski, M. L. (2000). Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians: A Randomized Trial. Jama, 283, 59-68.
[12] Parrott, S., & Godfrey, C. (2004). Economics of Smoking Cessation. Bmj, 328, 947-949.
[13] Phelps, C. (2012). Health Economics (5th ed.). Upper Saddle River, NJ: Pearson Education.
[14] Pierce, J. P., White, M. M., & Messer, K. (2009). Changing Age-Specific Patterns of Cigarette Consumption in the United States, 1992-2002: Association with Smoke-Free Homes and State-Level Tobacco Control Activity. Nicotine & Tobacco Research, 11, 171-177.
[15] Rathert, C., Huddleston, N., & Pak, Y. (2011). Acute Care Patients Discuss the Patient Role in Patient Safety. Health Care Management Review, 36, 134-144.
[16] Townsend, J., Roderick, P., & Cooper, J. (1994). Cigarette Smoking by Socioeconomic Group, Sex, and Age: Effects of Price, Income, and Health Publicity. Bmj, 309, 923-927.
[17] Trinidad, D. R., Pérez-Stable, E. J., Messer, K., White, M. M., & Pierce, J. P. (2010). Menthol Cigarettes and Smoking Cessation among Racial/Ethnic Groups in the United States. Addiction, 105, 84-94.
[18] US Department of Health and Human Services (2012). About Healthy People. Healthy People 2020.
[19] US Department of Health and Human Services (HHS) (2014) The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

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