Engaging Physicians and Pharmacists in Providing Smoking Cessation Counseling

Abstract

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.

Pharmacists’ Perceptions of Participation in a Community Pharmacy-Based Nicotine Replacement Therapy Distribution Program

“…Some survey items were drawn from published pharmacy-based cessation studies [11,18]. The survey, described in detail below, aimed to characterize the participating pharmacists, assess pharmacists' perceptions of program logistics and implementation, and assess perceptions of smoking cessation counseling activities.…”

Reducing Tobacco-Related Cancer Incidence and Mortality: Summary of an Institute of Medicine Workshop

“…CDC's media campaign, Tips from Former Smokers, was linked to a doubling of calls to quitlines and a tripling of unique visits to the website. With the evolving modes of communication and entertainment, tobacco education efforts are also expanding to the Internet, cell phone apps, social networking sites, video game kiosks, and computer tablets [76][77][78][79].…”

The Role of Academic Pharmacy in Tobacco Cessation and Control

“…This brief, minimal approach is known as the Ask-Advise-Refer model. Because most pharmacists are interested in providing cessation services, 17 yet few are able to integrate comprehensive tobacco cessation counseling into routine practice, 24 brief interventions are inherently appealing for the pharmacy profession American Journal of Pharmaceutical Education 2013; 77 (5) Article 93. and appear to be feasible in the pharmacy practice environment. [25][26][27][28][29] If broadly implemented, brief interventions (3 minutes or less) 19 could lead to a significant reduction in the national prevalence of tobacco use.…”

“…However, the majority of pharmacy practitioners lack the time and training to provide this level of service. 17,24 As an acceptable alternative, pharmacists in direct patient-care practice settings should receive training in how to conduct brief tobacco cessation interventions using the Ask-AdviseRefer approach. Community pharmacists could increase the number of brief cessation interventions conducted by assessing tobacco use status when creating new or updating existing patient profiles.…”