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Integrating smoking cessation treatment into primary care: an effectiveness study
Michael C Fiore1, Danielle E McCarthy, Thomas C Jackson
1Department of Medicine, University of Wisconsin Medical School, Milwaukee, WI 53233, USA. Mcf@ctri.medicine.wisc.edu
Preventive Medicine
|March 17, 2004
Summary
Free smoking cessation treatments offered in primary care were well-accepted by diverse smokers. While utilization was high, additional psychosocial support did not significantly improve long-term abstinence rates.
Area of Science:
- Public Health
- Behavioral Science
- Clinical Medicine
Background:
- Smokers often express lack of interest in cessation, but proactive offers of assistance are frequently accepted.
- Primary care settings are ideal for delivering smoking cessation interventions to diverse patient populations.
Purpose of the Study:
- To assess the acceptability, utilization, and effectiveness of free smoking cessation treatment.
- To evaluate treatment outcomes among diverse primary care patients.
Main Methods:
- Medical assistants invited 4174 adult smokers; 1869 enrolled and received free nicotine patch therapy.
- Participants could receive patches alone, with the Committed Quitters program, or with individual counseling.
- Acceptability, enrollment, patch pickup, and treatment choices were recorded.
Main Results:
- Nearly 68% accepted the invitation, 77% enrolled, and 85% of eligible smokers picked up free patches.
- 75% of participants chose psychosocial treatment alongside nicotine patches.
- 13% of treatment initiators achieved 7-day point-prevalence abstinence at 1 year; no significant treatment effects were observed.
- Minority patients showed higher initial interest but lower utilization compared to White patients.
Conclusions:
- Free, accessible smoking cessation treatment is accepted and utilized by diverse primary care patients.
- Psychosocial interventions combined with nicotine patches did not significantly enhance abstinence rates.
- Barriers, not lack of interest, may impede cessation treatment use among minority smokers.