Primary Care

Patients are more likely to stop smoking if they are advised by their doctors to do so

Cigarette smoking is responsible for one of five deaths in the United States, yet nearly one-quarter of adult Americans still smoke. The good news is that simple advice to quit from their doctors encourages many smokers to do just that. A new study found that 12 percent of patients who smoked had quit smoking 8 to 10 months after they completed a questionnaire about their smoking habit and readiness to quit and were counseled by their physicians to stop smoking.

In the study, which was supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00060), researchers from Tufts New England Medical Center and Blue Cross Blue Shield of Massachusetts compared alternative strategies for smoking cessation at a hospital-based adult primary care practice. A separate practice team implemented each strategy. The minimal intervention consisted of a smoking status "vital sign" stamp, which documented patient smoking status on each patient's chart. The enhanced intervention consisted of cessation counseling prompts for clinicians and a five-question form to be filled out by patients while in the physicians' offices.

The researchers collected medical record documentation of screening for smoking and cessation advice and self-reported patient smoking cessation rates 8-10 months after implementation. Smoking status was documented at 86 percent, 91 percent, and 49 percent of visits on the minimal, enhanced, and control groups, respectively, and cessation advice was given at 38 percent, 47 percent, and 30 percent, respectively. Self-reported smoking cessation was higher in the enhanced group (12 percent) compared with the minimal (2 percent) and control (4 percent) groups.

See "Smoking cessation in primary care: A clinical effectiveness trial of two simple interventions," by Catherine E. Milch, M.D., Janet M. Edmunson, M.Ed., Joni R. Beshansky, R.N., M.P.H., and others, in the March 2004 Preventive Medicine 38, pp. 284-294.

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