[Intervention against tobacco dependence in primary care. A study of 4 modalities of action]

To study the feasibility and evaluate the outcome over a years of four methods of combatting tobacco addiction at the primary care level: one directed towards the team's staff and three aimed at patients (counselling of smokers and specific treatment with nicotine chewing-gum and group or individual support). To compare the results of group and individual support.

Uncontrolled intervention study. SITE. Primary care.

19 members of the Team. 121 smoking patients who attended for consultation. 62 people who requested treatment.

Consensus on the attitude taken to tobacco within the team. Systematic counselling to smokers. Treatment with nicotine chewing-gum and group or individual support.

Numbers of people who gave up after a year: among the 12 smokers in the team, 4 (33%); 8 out of the 103 people who received counselling (7.7%) (Cl 2.60-12.94%); zero out of the 20 people who never attended for treatment or left the course after the first interview; zero out of the 20 treated in a group; and 8 out of the 20 treated individually (40%) (Cl 18.53-61.47%, p less than 0.001 regarding the treatment in group).

The results support the effectiveness of three of the methods of intervention at the Primary Care level: intervention within the team itself, systematic counselling to smokers and treatment using nicotine chewing-gum and individual support. Group support must be reserved for staff with a specific training on Tobacco Addiction and the dynamics of group treatment.