A Novel Decision Aid to Encourage Smoking Cessation Among Patients at an Urban Safety Net Clinic

A Novel Decision Aid to Encourage Smoking Cessation Among Patients at an Urban Safety Net Clinic

ORIGINAL RESEARCH — Volume 15 — October 11, 2018

Sumit D. Agarwal, MD1; Matthew Kerwin, MD2; Jacob Meindertsma, MD2; Andrew M.D. Wolf, MD3 (View author affiliations)

Suggested citation for this article: Agarwal SD, Kerwin M, Meindertsma J, Wolf AM. A Novel Decision Aid to Encourage Smoking Cessation Among Patients at an Urban Safety Net Clinic. Prev Chronic Dis 2018;15:180215. DOI: http://dx.doi.org/10.5888/pcd15.180215.

PEER REVIEWED

On This Page

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Abstract

Introduction

Decision aids are not readily available to individualize the benefits of smoking cessation but could help health care providers engage in meaningful conversations with their patients to explore and encourage an attempt to quit smoking. We conducted a pilot study of a novel decision aid among an underserved population to assess its effectiveness in increasing readiness to quit and quit attempts.

Methods

We designed a decision aid that used images of birthday cakes to highlight the number of years of life that could be gained from smoking cessation and tested it in an urban safety net clinic. Active adult smokers were randomized to receive smoking cessation counseling, either with motivational interviewing techniques alone (control) or with motivational interviewing and the decision aid (intervention). The primary outcome assessed was readiness to quit, measured by using a previously validated contemplation ladder. The secondary outcome assessed was making a quit attempt.

Results

Immediately following the interview, 21.1% of patients rose on the readiness-to-quit ladder; at 1 month, 40.6%; and at 3 months, 46.6%. We saw no significant difference between the control and intervention groups immediately after the interview (P = .79), at 1 month (P = .92), or at 3 months (P = .79). Over the 3-month follow-up period, 25% of patients in the control group made a quit attempt, and 15.4% of patients in the intervention group made a quit attempt (P = .30). Patients found the decision aid useful and easy to understand.

Conclusion

Patients from an underserved population were highly receptive to a visual and personalized decision aid that highlighted the positive impact of smoking cessation. However, we found no difference in readiness to quit between patients who received motivational interviewing with the decision aid or without it.