The impact of smoking status on trust in general practitioners: a nationwide survey of smokers and ex-smokers

Background: Trust is important to therapeutic relationships, influences patients’ motivation to seek care, cooperate during clinical examinations, adhere to treatment, return for follow-up, and facilitates exchange of health information. The aim of this study was to determine the influence of smoking status on patients’ trust in GPs, and how trust is related to willingness to act on advice to quit smoking. Methods: A nationwide, online, cross-sectional survey was conducted among Australian smokers and ex-smokers aged 35 years and older. Participants were asked to rate their trust in GPs on a scale from 0 to 10, where 0 describes “you don’t trust GPs” and 10 describes “you trust GPs completely”. Multivariate linear and logistic regression analyses were used to test hypotheses. Results: Responses from 886 respondents were analysed. Mean age was 60 years (± 9.5) and most were current smokers (69%). Trust scores were comparable for both smokers and ex-smokers (mean 7.6 (± 2.4)), but 39.4% were classified as having low trust (score < 8). Anticipated stigma was negatively associated with level of trust in GPs. Communication experience was positively associated with level of trust in GPs. Higher level of trust in GPs was associated with acceptance of advice to quit smoking. Conclusion: Smokers and ex-smokers with higher levels of trust in their GPs reported more positive communication, and felt GPs advised them to quit smoking in a way that motivated them to quit. GP awareness with regard to anticipated stigma and experiences of communication amongst patients with a smoking history could improve provision of smoking cessation advice for this group.