Tobacco control efforts in managed care: what do the doctors think?

Area of Science:

• Public Health
• Health Services Research
• Tobacco Control

Background:

• Health plans provide tobacco control guidelines and cessation support.
• Physician awareness and implementation of these supports are crucial for effectiveness.
• Dissemination and implementation of health plan initiatives require validation.

Purpose of the Study:

• To assess physician awareness of health plan tobacco control guidelines and cessation support coverage.
• To validate the dissemination and implementation of health plan tobacco cessation support materials in clinical settings.
• To compare physician-reported data with health plan-reported data on tobacco control activities.

Main Methods:

• A survey was administered to 100 randomly selected primary care physicians associated with 9 nonprofit health plans.
• Physicians were surveyed about their health plan's tobacco cessation guidelines, coverage, and support for clinician action.
• Survey responses were compared with data reported by the respective health plans.

Main Results:

• A 91% response rate was achieved.
• While 88% of physicians were aware of their health plan's tobacco cessation guidelines, awareness of specific coverage for medications, cessation classes, or counseling was significantly lower.
• Physician reports of cessation support during patient care showed little correlation with health plan reports of these supports.

Conclusions:

• Physician reports can serve as a valuable tool for verifying the dissemination and implementation of health plan tobacco control activities.
• Even in high-performing health plans, there is substantial room for improvement in the implementation and communication of tobacco cessation support.
• Further efforts are needed to ensure comprehensive understanding and utilization of available cessation resources by both physicians and patients.