Relationship between tobacco control policies and the delivery of smoking cessation services in nonprofit HMOs.
BACKGROUND
This project examined tobacco policies and delivery of cessation services in nonprofit HMOs that collectively provide comprehensive medical care to more than 8 million members.


METHODS
Three annual surveys with health plan managers showed that all of these health plans had written tobacco control guidelines that became more comprehensive over the span of this study. We also surveyed a random sample of 4207 current smokers who had attended a primary care visit in the past year (399-528 at each of nine health plans).


RESULTS
Of these smokers, 71% reported advice to quit, 56% were asked about their willingness to quit, 49% were provided some assistance in quitting (mostly self-help material or information about classes or counseling), and 9% were offered some kind of follow-up. Smokers receiving assistance in quitting reported higher satisfaction with their care.


CONCLUSIONS
In general, health plans with the most comprehensive policies also showed higher rates of implementing tobacco treatment programs in primary care. Compared with tobacco control efforts of a decade or more ago, considerable progress has been made. However, there is still room for improvement in the proportion of smokers who receive the most effective forms of assistance in quitting.
Stevens
Victor J
VJ
Kaiser Permanente Center for Health Research Northwest, 3800 N. Interstate Ave., Portland, OR 97227, USA. victor.j.stevens@kpchr.org
Solberg
Leif I
LI
Quinn
Virginia P
VP
Rigotti
Nancy A
NA
Hollis
Jack A
JA
Smith
K Sabina
KS
Zapka
Jane G
JG
France
Eric
E
Vogt
Thomas
T
Gordon
Nancy
N
Fishman
Paul
P
Boyle
Raymond G
RG
D000328:Adult; D003625:Data Collection; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012907:Smoking; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D019460:Tobacco Industry / Q000331:legislation & jurisprudence; D014026:Nicotiana