Encouraging primary care physicians to help smokers quit. A randomized, controlled trial.
OBJECTIVE
To increase the effect that primary care physicians have on their patients who smoke.


METHODS
Randomized, controlled trial with 112 general internists and their patients who smoke.


METHODS
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.


METHODS
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).


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 less than 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.
Cohen
S J
SJ
Indiana University School of Medicine, Indianapolis.
Stookey
G K
GK
Katz
B P
BP
Drook
C A
CA
Smith
D M
DM
D000328:Adult; D002638:Chewing Gum; D003376:Counseling / Q000379:methods; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage; D010044:Outpatient Clinics, Hospital; D010819:Physician's Role; D010821:Physicians, Family; D011897:Random Allocation; D012380:Role; D014029:Tobacco Use Disorder / Q000534:rehabilitation*
D002638:Chewing Gum; D009538:Nicotine