[Smoking cessation in primary and specialized care: a real opportunity and a public health necessity]

To determine whether primary care provides a suitable framework for integrated treatment aimed at smoking cessation with systematic minimal intervention or pharmacological treatment with nicotine replacement therapy (NRT). To compare the results with those obtained in a specialized pneumology unit.

Prospective, quasi-experimental study.

Primary and specialized care services.

357 smokers who were followed at a health center (166) or a specialized clinic (191) during a 6-month period.

Two types of intervention were used depending on the patients' degree of nicotine dependence: systematic minimal intervention for those with low dependence or who were still in the contemplation or precontemplation phase, and NRT for those with high dependence, in the preparation phase.

Twelve months after the start of the study, abstinence among participants who received systematic minimal intervention was 36.5% in primary care patients and 41.8% in specialized care patients (P>.05). Among participants who received NRT abstinence was 37.1% in the former group and 35.5% in the latter (P>.05). The percentage of patients lost to follow-up was 8.6% in specialized care and 6.3% in primary care.

The results lead us to recommend smoking cessation treatment integrated in the primary care setting, either with systematic minimal intervention or NRT.