title: Awakening the sleeping giant: mainstreaming efforts to decrease tobacco use in an HMO.
abstract: Group Health Cooperative (GHC) of Puget Sound is developing, within a framework of quality improvement, a comprehensive population-based approach to decreasing the prevalence of tobacco use. Broad organizational support has been obtained, centralized support is being integrated with clinic-level activity, local ownership of outcomes is encouraged with empowerment of health care teams, and support for community and policy-based activities is being provided. GHC's smoking prevalence has decreased from 25% to 15.5% over the past decade, while the state of Washington's prevalence declined from 23.7% to 21.8%.
authors.affiliation: Group Health Cooperative of Puget Sound, Seattle, WA 98101, USA.
authors.forename: T
authors.initials: T
authors.lastname: McAfee
authors.forename: J
authors.initials: J
authors.lastname: Wilson
authors.forename: S
authors.initials: S
authors.lastname: Dacey
authors.forename: N
authors.initials: N
authors.lastname: Sofian
authors.forename: S
authors.initials: S
authors.lastname: Curry
authors.forename: B
authors.initials: B
authors.lastname: Wagener
mesh_terms: D018672:Community Health Planning / Q000458:organization & administration*; D006266:Health Education; D006279:Health Maintenance Organizations / Q000458:organization & administration / Q000592:standards*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008282:Mainstreaming, Education; D009538:Nicotine / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D014861:Washington / Q000453:epidemiology