Nurse-assisted smoking counseling in medical settings: minimizing demands on physicians.
BACKGROUND
In an effort to find more practical smoking intervention models for primary-care settings, three physician-and-nurse team approaches to patient counseling were compared with brief physician advice alone.


METHODS
Subjects were 3,161 adult smokers surveyed while waiting to see 1 of 40 primary-care physicians. Physicians delivered a brief stop-smoking prompt to 2,707 (86%) of these smokers and referred them to an on-site smoking counselor (e.g., nurse) who randomly provided a two-page pamphlet (advice-only control) or one of three brief nurse-assisted interventions: (a) self-quit training, (b) recruitment to a group program, or (c) a combination intervention. Smokers usually (87%) agreed to see the counselor.


RESULTS
After 3 months, subjects in the three nurse-assisted conditions were more likely to report a serious quit attempt (50% vs 39%, P less than 0.001) than were physician-advice-only subjects. Quit rates at 3 months were also higher (P less than 0.001) in the nurse-assisted self-quit (12.9%), recruitment (14.1%), and combination (13.0%) conditions, compared with those for brief physician advice only (7.6%).


CONCLUSIONS
If long-term efficacy is confirmed, these nurse-assisted counseling approaches will serve as practical smoking intervention models for most medical-care delivery settings.
Hollis
J F
JF
Kaiser Permanente Center for Health Research, Portland, Oregon 97215.
Lichtenstein
E
E
Mount
K
K
Vogt
T M
TM
Stevens
V J
VJ
D000328:Adult; D003376:Counseling; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D008297:Male; D009726:Nurses; D010820:Physicians; D011320:Primary Health Care; D000074606:Smoking Prevention