Encouraging primary care physicians to help smokers quit. A randomized, controlled trial
Cohen, S.J.; Stookey, G.K.; Katz, B.P.; Drook, C.A.; Smith, D.M.
Annals of Internal Medicine 110(8): 648-652
1989
ISSN/ISBN: 0003-4819 PMID: 2930095 Document Number: 336820
A study was undertaken to increase the effect that primary care physicians have on their patients who smoke. A sample of 1420 patients from a general medicine clinic of a city-county teaching hospital, who smoke at least one cigarette a day were recruited regardless of their interest in quitting smoking. 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); nicotine gum was freely available to patients (gum); stickers were attached to their smokers' charts (reminder); or both gum and remainders (both). 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. 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.