Enhancing smoking cessation rates in primary care

Area of Science:

• Public Health
• Behavioral Science
• Clinical Medicine

Background:

• The Agency for Health Care Policy and Research (AHCPR) guidelines emphasize physician-led smoking cessation interventions.
• Physician adoption of smoking cessation guidelines remains suboptimal despite recognized importance.
• This study aimed to compare practice-based versus community-based smoking cessation counseling.

Purpose of the Study:

• To evaluate the comparative effectiveness of two distinct smoking cessation counseling strategies.
• To assess the impact of practice-based versus community-based counseling on smoking cessation rates.
• To determine the feasibility of training healthcare professionals in smoking cessation interventions.

Main Methods:

• Two counseling approaches were compared: practice-based (office nurses, telephone counselors) and community-based (telephone counselors only).
• Both approaches included 1 recruitment and 6 computer-assisted counseling sessions.
• Study involved 487 smokers across 4 practices in mid-Michigan, with physicians trained in brief advice.

Main Results:

• Six-month quit rates were comparable: 35% for practice-based and 36% for community-based counseling.
• Higher quit rates were observed in participants completing at least 4 counseling sessions.
• Sixty-two percent of participants received free nicotine replacement therapy.

Conclusions:

• Nurses and counselors can be effectively trained to deliver relapse-prevention counseling in primary care settings.
• Both office-based and telephone-delivered counseling methods demonstrated increased smoking cessation rates.
• The study supports the integration of trained professionals in delivering smoking cessation support.