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Assessing smoking-cessation programs Does the 5A program work?

Cigarette smoking continues to be the principal cause of premature death in the nation and a major cause of medical expenditures and lost productivity. Of the 46.5 million adults in the United States who smoke, about 70% will see a primary care provider at least once a year. The United States Public Health Service (USPHS), in an effort to reduce cigarette smoking, recommends a 5-step process that includes: (1) Asking every patient about tobacco use, (2) Advising all smokers to quit, (3) Assessing smokers' willingness to make a quit-attempt, (4) Assisting smokers with treatment and referrals, and (5) Arranging follow-up contacts. Does this "5A" program work?

A study published in the August issue of the American Journal of Preventive Medicine provides the most comprehensive assessment yet available on the delivery of smoking cessation services recommended by the USPHS clinical practice guideline for tobacco. Results demonstrate substantial clinician compliance with the guideline and highlight areas in need of improvement. In contrast to commonly-held beliefs, smokers reported they wanted their doctors to discuss cessation at most medical visits, and were more satisfied with their health plan when they received help with quitting.

Researchers from 7 organizations across the United States, including managed healthcare providers, health research centers and medical schools, evaluated the results of a survey mailed to almost 65,000 participants in 9 non-profit Health Maintenance Organizations. There was a 70% response rate to the survey and about 10% of the respondents were smokers. From this sample of about 4200 smokers, the extent of compliance with the "5A" treatment model was measured.

Although most smokers were asked about smoking (90%) and more than two-thirds (71%) were advised to quit, only about half were assessed for their willingness to quit (56%) and given assistance for quitting (49%). Arrangements for follow-up were only provided to
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19-Jul-2005


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