Training intake clinicians at primary care facilities to use specific, guideline-based methods to encourage their patients who smoke to quit increases the likelihood that their patients will successfully quit smoking, according to a study published in the April 21 issue of the Journal of the National Cancer Institute. Intake clinicians are nurses and medical assistants who document the reasons for an office visit and check patients' vital signs.

In 1996 (and updated in 2000), the Agency for Healthcare Research and Quality (AHRQ) released its Smoking Cessation Clinical Practice Guideline, which recommends that all clinicians strongly advise patients who smoke to quit and instructs them in methods to help their patients successfully quit. Many physicians, however, do not advise their patients to stop smoking because they do not believe it will work. In addition, physicians may lack the time and personnel to provide their patients with assistance for smoking cessation.

To study the effectiveness of the AHRQ Guideline, David A. Katz, M.D., M.Sc., formerly of the University of Wisconsin-Madison, and colleagues conducted a randomized, controlled trial among 2163 adult smokers at eight primary care clinics--four test sites and four control sites--in southern Wisconsin. At the test sites, intake clinicians were instructed in how to assess a patient's smoking status and offer assistance to those patients who wished to quit smoking. These patients were offered, free of charge, nicotine patches and/or proactive telephone counseling to assist them in quitting. Staff at the control sites received only general information about the AHRQ Guideline. Patients' self-reported abstinence from smoking was assessed by telephone interviews 2 and 6 months after the initial visit.

Clinicians at test sites followed the Guideline more often than those at the control sites. Test site patients were more likely than control site patients to be asked about their sm
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Contact: Sarah L. Zielinski
jncimedia@oupjournals.org
301-841-1287
Journal of the National Cancer Institute
20-Apr-2004

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