Research Activities, August 2010: Outcomes/Effectiveness Research: Using quitlines with physician support improves smoking cessation

Outcomes/Effectiveness Research
Using quitlines with physician support improves smoking cessation
Most people would agree that quitting smoking is not easy. Primary care physicians do their part by encouraging patients to quit, but they have little time to engage in lengthy interventions. Telephone quitlines have been found to be effective for counseling and helping smokers to quit. A new study shows that collaboration between physicians and quitlines can boost smokers' chances of getting the support they need to quit smoking.

A total of 1,817 smokers from 16 primary care practices participated in the study. Physicians used an expanded "vital sign" intervention that included asking patients if they smoke, advising tobacco cessation if they do, assessing their interest in quitting, and referring interested patients to a quitline via fax. The quitline offered four telephone counseling sessions as well as contact with the physician for possible drug therapy and followup. Exit surveys given by trained research assistants asked patients who smoked about counseling they received in the office and if they were referred to a quitline. A control group of primary care practices just used the traditional tobacco use vital sign (identifying patients who never smoked, used to smoke, or currently smoke) without a system for patient assessment and referral. The percentage of smokers receiving cessation support was 40.7 percent in the intervention group and 28.2 percent in the control group. Implementing the systematic process resulted in a significant increase of in-office discussion of quitting smoking as well as referrals to quitlines.

The researchers found a greater frequency of cessation support in patients aged 35-54 years, and with male and more experienced primary care physicians. Both physicians and office managers were satisfied with how the intervention worked and the comfort level of patients being asked about their smoking habits. The study was supported in part by the Agency for Healthcare Research and Quality (HS14854).

See "Promoting primary care smoking-cessation support with quitlines," by Stephen F. Rothemich, M.D., M.S., Steven H. Woolf, M.D., M.P.H., Robert E. Johnson, Ph.D., and others in the April 2010 American Journal of Preventive Medicine 38(4), pp. 367-374.

Research Activities, August 2010: Outcomes/Effectiveness Research: Using quitlines with physician support improves smoking cessation