| Summary: | A random sample of GPs stratified by their attitudes towards discussing smoking with patients, each had one surgery session video-recorded. Attending patients completed questionnaires, which identified smokers and recorded their likelihood of attempting to quit smoking. The characteristics of patients and GPs who agreed and refused to be video-recorded were noted. GPs were shown video-recordings before semi-structured interviews explored their reasons for discussing or not discussing smoking during consultations. In a separate study, smokers' consulting behaviours were described. Results. GPs view advice-giving as a challenging task that they prefer to approach in a problem-based manner to preserve good doctor: patient relationships. Behaviours, which may indicate smokers who are more likely to make quit attempts, are reliably and validly described. Younger patients and those presenting with overt mental health problems are less likely to consent to video recording of consultations. Younger GPs and those working in teaching and training practices are more likely to agree to video recording of consultations. Conclusions. Strategies to increase the provision of anti-smoking advice given by GPs should take into account GPs' preferences for giving advice in a problem-based manner. Further research could produce methods of identifying, at the time of their consultations, smokers likely to respond positively to advice. Researchers who use video-recorded consultations must consider how this technique could influence their study findings.
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