Patient referral to a smoking cessation program: who follows through?
Lichtenstein, E.; Hollis, J.
Journal of Family Practice 34(6): 739-744
1992
ISSN/ISBN: 0094-3509 PMID: 1593248 Document Number: 395634
Background: While health care providers are often urged to refer smokers to a smoking cessation program, little information is available about patient adherence to such advice. Methods: A group of primary care patients who smoked (N = 1380) received brief advice to quit from their provider, and were then asked to stay and talk to a counselor for more information. Counselors randomly delivered one of two interventions. For the intervention group, referral to a specific group cessation program was emphasized, and for the control group, quitting advice was merely repeated. The referral intervention included a video in which role models testified to the acceptability and usefulness of the HMO's group program. The usual program free were waived, and patients received a supportive, follow-up telephone call 1 week after their visit. Results: In the referral intervention group, 53.2% of patients agreed to go to the cessation program and 11.,3% actually attended, compared with only .006% of the patients who received advice only. Logistic regression analyses revealed that patients who were contemplating quitting were more than five time a likely to respond to the referral compared to precontemplators (smokers who were not seriously considering quitting). Older, heavier smokers were also more likely to attend a group session. Conclusion: An intensive, specific referral to a group smoking cessation program can increase participation by patients. Most patients, however, will not attend a group program; therefore, a brief office-based intervention for all smokers should percede referral.