title: The feasibility of connecting physician offices to a state-level tobacco quit line.
abstract: BACKGROUND
  Telephone counseling for tobacco cessation is an effective and evidence-based approach to address tobacco use. The wide dissemination of region- and state-level quit lines has been a major goal for public health agencies. However, connecting patients in primary care settings to state-level quit lines has not been evaluated.
  
  
  METHODS
  Observational study describing two methods (fax referral and providing a brochure) to connect private physician offices with a state-level quit line in Oregon. This study describes the resources required to create a clinical pathway for the 5A's in primary care (ask, advise, assess, assist, and arrange) using a state-level telephone quit line as an intervention for cessation in primary care clinics sharing a common electronic medical record system, focusing on the costs and generalizability of this approach.
  
  
  RESULTS
  Of the 15,662 smokers identified in 19 primary care clinics, 745 patients were referred to the Oregon Tobacco Quit Line during the study period. The program cost in the first year was $15 to $22 per patient connected with the quit line; in subsequent years, the cost decreased to $4 to $6 per quit-line connection.
  
  
  CONCLUSIONS
  Connecting private physician offices to a state-level quit line is feasible, can be accomplished at low cost with minimal use of resources, and may be cost effective. Regional, state, and local tobacco quit lines should consider a physician office "quit-line connection" as a practical approach to increase utilization.
authors.affiliation: Providence St. Vincent Hospital and Medical Center, Portland, Oregon 97225, USA. charles.bentz@providence.org
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Bentz
authors.forename: K Bruce
authors.initials: KB
authors.lastname: Bayley
authors.forename: Kerry E
authors.initials: KE
authors.lastname: Bonin
authors.forename: Lori
authors.initials: L
authors.lastname: Fleming
authors.forename: Jack F
authors.initials: JF
authors.lastname: Hollis
authors.forename: Timothy
authors.initials: T
authors.lastname: McAfee
mesh_terms: D000328:Adult; D003159:Community-Institutional Relations; D003365:Costs and Cost Analysis; D003376:Counseling / Q000379:methods*; D019091:Critical Pathways; D034742:Electronic Mail; D005240:Feasibility Studies; D005260:Female; D015277:Hotlines / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009922:Oregon; D010174:Pamphlets; D010824:Physicians' Offices / Q000458:organization & administration*; D015397:Program Evaluation; D011635:Public Health Administration; D012017:Referral and Consultation; D016540:Smoking Cessation / Q000379:methods*; D013219:State Government