Stuart J. Cohen, EdD; George K. Stookey, PhD; Barry P. Katz, PhD; Catherine A. Drook, BS; David M. Smith, MD
Study Objective: To increase the effect that primary care physicians have on their patients who smoke.
Design: Randomized, controlled trial with 112 general internists and their patients who smoke.
Patients: Sample of 1420 patients from a general medicine clinic of a city-county teaching hospital, who smoke at least one cigarette a day and were recruited regardless of their interest in quitting smoking.
Interventions: Physicians were randomly assigned to one of four groups: participants who received a protocol for smoking management and a lecture on the consequences and management of smoking (control); in addition, had nicotine gum freely available to patients (gum); had stickers attached to their smokers' charts (reminder); or had both gum and reminders (both).
Measurements and Main Results: The percentage of patients with a return visit at 6 months who quit smoking (alveolar carbon monoxide of less than nine parts per million) was 1. 3% (control), 7.7% (gum), 7.0% (reminders), and 6.3% (both). At 1 year the percentages were 2.7%, 8.8%, 15.0%, and 9.6%, respectively. Subsequent pairwise comparisons showed that the three intervention groups were not significantly different, but that each was significantly different from the control group (P < 0.05). Physicians in all three intervention groups spent significantly more time than did the physicians in the control group counseling their patients about smoking.
Conclusions: The availability of nicotine gum or labeling the charts of smokers can help primary care physicians increase their success rates two- to six-fold in helping patients quit smoking. If all primary care physicians used these procedures, they could help an additional 2 million smokers quit.
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Cohen SJ, Stookey GK, Katz BP, Drook CA, Smith DM. Encouraging Primary Care Physicians To Help Smokers Quit: A Randomized, Controlled Trial. Ann Intern Med. 1989;110:648-652. doi: 10.7326/0003-4819-110-8-648
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Published: Ann Intern Med. 1989;110(8):648-652.
Cardiology, Coronary Risk Factors, Smoking, Tobacco, Alcohol, and Other Substance Abuse.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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