Background Health professionals have a proven, positive impact on patients’ ability to quit smoking, yet few integrate cessation counseling into routine practice.The aim of this study was to evaluate the impact of continuing education training on physicians’ and pharmacists’ cessation counseling. Methods A group-randomized trial of health care providers (87 physicians and 83 pharmacists) from 16 Texas communities compared smoking cessation training (intervention group) with skin cancer prevention training (control group). Pretraining, posttraining, and extended follow-up surveys were collected from providers. Perceived ability, confidence, and intention (ACI) to address smoking with patients were assessed with a composite ACI index. Patient exit interviews (at baseline, 1452 patients completed interviews; after 12 months, 1303 completed interviews) assessed counseling practices. Results There was a significant increase in the percentage of physicians with a high ACI index in the intervention group from pretraining to posttraining (27% to 73%; P <.001) vs the control group (27% to 34%; P=.42) and for pharmacists (4% to 60%; P <.001) vs the control group (10% to 14%; P=.99). Similar results were seen from pretraining to extended follow-up. At baseline, fewer pharmacy patients reported being asked about smoking compared with patients seen by physicians (7% vs 33%; P=.001). There was an increase in assisting patients to quit (6% to 36%; P=.002) by physicians (baseline vs 12 months) in the intervention group, but not in the control group. Conclusions Training led to significant and lasting improvement in counseling among physicians. Low levels of counseling were seen among pharmacists.

PKCε prevents the phenotypic progression of the OA chondrocyte, acting on cartilage specific markers through the modulation of the transcription factors SOX9 and RUNX2. The loss of PKCε enhances, in fact, the OA hypertrophic phenotype, with clear implications in the pathophysiology of the disease.

This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and public health. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the public health issues that are key risk factors for the onset and exacerbation of diseases. The authors further suggest that the educational activities of the CS2day initiative functioned as Type III translational science in that it facilitated the use of research-derived practice guidelines in clinical practice and in the community. The article concludes by stating that the successful results of the CS2day initiative illustrate what can happen when continuing education efforts develop from a public health problem rather than just a practice gap identified in a clinical practice setting.