Smoking intervention: the expanding role of the physician.

Ockene, Judith K.

doi:10.2105/ajph.77.7.782

Cited by 80 publications

(28 citation statements)

References 17 publications

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“…The RA invited patients to complete a self-administered questionnaire, providing limited assistance with uncompleted entries and offering no cessation counseling. Informed consent 23,24 we produced a composite question for A [3][4][5] (If you smoke, did your doctor talk with you today about ideas or plans to help you quit smoking?) out of concern that too lengthy a questionnaire would compromise patient participation.…”

Section: Data Collectionmentioning

confidence: 99%

“…1 Tobacco use is the leading cause of death in the United States, claiming an estimated 440,000 lives per year. 2,3 Health professionals play a key role in promoting tobacco cessation: smokers cite physician advice as a major determinant in quitting, 4,5 and even simple advice from physicians has been shown to signifi cantly increase abstinence rates. 6 If clinicians helped as few as 10% of smokers to quit, 3.5 million smokers would become tobacco free each year.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17] Well-designed studies are needed both to confi rm whether the vital sign intervention increases counseling and to clarify the intensity of any resultant counseling as defi ned by the "5As" framework (Table 1). Because simple advice to quit (A 2 ) is less effective in promoting abstinence than more intensive counseling (A [3][4][5] ), [18][19][20][21] knowing whether the vital sign intervention increases not only A 2 but also A 3-5 is essential. We therefore conducted a cluster-randomized, controlled trial of the vital sign intervention comparing patientreported rates of tobacco cessation counseling at practices that asked each adult patient about tobacco use when measuring vital signs (intervention) and at practices that continued their usual routine (control).…”

Section: Introductionmentioning

confidence: 99%

“…We therefore conducted a cluster-randomized, controlled trial of the vital sign intervention comparing patientreported rates of tobacco cessation counseling at practices that asked each adult patient about tobacco use when measuring vital signs (intervention) and at practices that continued their usual routine (control). We examined not only the overall counseling rates (A [2][3][4][5] ) but also the intensity of counseling (A 2 vs A [3][4][5] ).…”

Section: Introductionmentioning

confidence: 99%

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Effect on Cessation Counseling of Documenting Smoking Status as a Routine Vital Sign: An ACORN Study

Rothemich¹,

Woolf²,

Johnson³

et al. 2008

The Annals of Family Medicine

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PURPOSE Guidelines encourage primary care clinicians to document smoking status when obtaining patients' blood pressure, temperature, and pulse rate (vital signs), but whether this practice promotes cessation counseling is unclear. We examined whether the vital sign intervention infl uences patient-reported frequency and intensity of tobacco cessation counseling. METHODSThis study was a cluster-randomized, controlled trial conducted in the Virginia Ambulatory Care Outcomes Research Network (ACORN). At intervention practices, nurses and medical assistants were instructed to assess the tobacco use status of every adult patient and record it with the traditional vital signs. Control practices did not use any systematic tobacco screening or identifi cation system. Outcomes were the proportion of smokers reporting clinician counseling of any kind and the frequency of 2 counseling subcomponents: simple quit advice and more intensive discussion.RESULTS A total of 6,729 adult patients (1,149 smokers) at 18 primary care practices completed exit questionnaires during a 6-month comparison period. Among 561 smokers at intervention practices, 61.9% reported receiving any counseling, compared with 53.4% of the 588 smokers at control practices, for a difference of 8.6% (P = .04). The effect was largely restricted to simple advice, which was reported by 59.9% of intervention patients and 51.5% of control patients (P = .04). There was no signifi cant increase in more extensive discussion, with 32.5% and 29.3% of patients at intervention and control practices, respectively, reporting this type of counseling (P = .18). CONCLUSIONSThe vital sign intervention promotes tobacco counseling at primary care practices through a modest increase in simple advice to quit. When implemented as a stand-alone intervention, it does not appear to increase intensive counseling.

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Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect on Cessation Counseling of Documenting Smoking Status as a Routine Vital Sign: An ACORN Study

Rothemich¹,

Woolf²,

Johnson³

et al. 2008

The Annals of Family Medicine

View full text Add to dashboard Cite

show abstract

“…[7][8][9] Studies have shown that very brief advice from the doctor yields one year quit rates of 5-10%, [10][11][12] and interventions that are more comprehensive, including follow up sessions, produce abstinence rates of 20-36%. [13][14][15] Another important way to control tobacco use is to encourage medical schools to teach about tobacco issues in the curriculum. It is vital that medical students, the future medical practitioners, have adequate knowledge of smoking related diseases and skills in smoking cessation.…”

mentioning

confidence: 99%