Increasing the efficacy of physician-delivered smoking interventions

Publisher Website
Google Scholar
Abstract
Objective:To assess the relative impacts of three physician-delivered smoking interventions in combination with follow-up contact from behavioral counselors. Design:Randomized controlled trial with pre-post measures of smoking rates. This paper reports six-month outcome data. Setting:Participants were recruited from among patients seen by 196 medical and family practice residents in five primary care clinics. Participants:Participants were 1,286 patients out of 1,946 eligible smokers approached. The patient group was 57% female and 91% white, had an average age of 35 years, and smoked, on average, slightly over one pack per day. Intervention:Physicians were trained to provide each of three interventions: advice only, brief patient-centered counseling, and counseling plus prescription of nicotine-containing gum (Nicorette™). Half the patients received follow-up in the form of telephone counseling at three-monthly intervals from behavioral counselors. Measurements and main results:Changes in smoking behaviors were assessed by telephone interview six months after physician intervention. The differences in one-week point prevalence cessation rates among the physician interventions were significant (p. Conclusion:Smoking intervention counseling provided by physicians is well received by patients and significantly increases the likelihood of cessation at six months, an effect that is augmented by the prescription of nicotine-containing gum, when compared with physician-delivered advice. Follow-up telephone counseling does not contribute significantly to smoking behavior changes.