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Effectiveness of smoking cessation interventions integrated into primary care practice
R S Thompson1, M E Michnich, L Friedlander
1Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98121.
Medical Care
|January 1, 1988
Summary
Physician counseling combined with National Cancer Institute (NCI) materials improved smoking cessation behaviors. Referral to classes was ineffective, suggesting intensive, relapse-prevention strategies are key for primary care success.
Area of Science:
- Public Health
- Behavioral Medicine
- Primary Care Research
Background:
- Smoking cessation interventions in primary care are crucial for public health.
- Effectiveness of different intervention modalities varies significantly.
- Relapse prevention strategies are increasingly recognized as important for sustained cessation.
Purpose of the Study:
- To evaluate the effectiveness of three distinct smoking cessation interventions in routine primary care.
- To compare physician counseling, National Cancer Institute (NCI) materials, and referral to cessation classes.
- To identify optimal strategies for smoking cessation within a primary care setting.
Main Methods:
- A complete factorial design was employed to test three interventions.
- Thirty-seven family practice physicians participated across three outpatient facilities.
- Patient participation and follow-up rates were high (95% and 92%, respectively).
Main Results:
- No single intervention significantly impacted point prevalence of quitting at 8-9 months.
- Combining physician counseling with NCI materials doubled the odds of significant antismoking behavior.
- Referral to smoking cessation classes proved ineffective, with low investigation rates.
Conclusions:
- Integrated interventions, such as physician counseling and educational materials, show promise for enhancing smoking cessation.
- Standalone referrals to cessation classes are not effective in this primary care context.
- Future efforts should focus on intensive, multi-occasion interventions incorporating relapse prevention principles.