Research in general practice for smokers and excessive drinkers in Australia and the UK. I. Interpretation of results.

This review examines the role of the general practitioner in assisting patients to stop smoking and in reducing levels of excessive drinking. After over a decade of clinical trials, we discuss what interventions work in general practice and interpret the results of clinical trials conducted predominantly in Australia and the UK. Studies have generally found a superiority of GPs' brief advice over non-intervention groups. Very brief GP advice results in smoking abstinence rates from 5% to 10%, reduction in alcohol consumption of around 25-35% and reduction in proportions of excessive drinkers of around 45%. The greater investment of GPs' time and the more comprehensive interventions which include follow up usually resulted in higher abstinence rates among smokers from between 20% to 36%, and reduction in proportions of excessive drinkers of up to 60-70%. The contributions of the adjuncts nicotine chewing gum, follow up visits and the personalization of health effects are discussed. It is difficult to make comparisons between studies and we examine some of the reasons. The predictors of successful outcome are presented as they are of particular interest to GPs in terms of targeting health promotion activities.