Direct Observation of Smoking Cessation Activities in Primary Care Practice

Conclusions

Although smoking cessation is be a common topic in some physician-patient encounters, there are widespread variations in how it is addressed in primary care practices. More comprehensive and efficient management of nicotine dependence may be possible if physicians addressed the infrastructure in their offices that can support smoking cessation activities. Many physicians may not yet be considering changing their office systems to enhance smoking cessation activities. Further efforts will be needed to identify the barriers to system changes and to help physicians integrate effective and efficient smoking cessation systems into their practices.

Acknowledgments

Partial funding for this project was provided through the following grants: The Robert Wood Johnson Foundation Generalist Physicians Faculty Scholars award (#032686, J.S. Ahluwalia); Kansas Academy of Family Physicians (J. Gladden); J.H. Baker Trust of La Crosse, Kansas (J Gladden); Kansas Association for Medically Underserved (J. Gladden); and a Primary Care Physician Education grant from the Kansas Health Foundation. We would like to thank the family physicians who not only provided a valuable learning experience for the students but also allowed the data collection necessary for our paper. We appreciate the commitment of the students who collected the data. We would like to thank Kristin Hedberg, MA, for preliminary data analysis and Timothy P. Daaleman, DO, and Delwyn Catley, PhD, for their careful review of early versions of this manuscript.

Related Resources

For Patients:

• QuitNet https://www.quitnet.com/qn_main.jtml Developed by Boston University, this site provides information and tools to people trying to quit smoking. It contains peer support programs, information on pharmaceuticals, a directory of local smoking cessation programs, and the latest news from the tobacco front.
• Quitsmokingsupport.com https://www.quitsmokingsupport.com/intro.htm This advertiser-supported site has dozens of pages on weight control, methods, interactive chat/support rooms, quit smoking articles, smokers’ lungs, etc.

For physicians:

• Smoking cessation guidelines. https://www.surgeongeneral.gov/tobacco/default.htm Clinical practice guidelines from the Surgeon General’s Web site with full text and references for online retrieval. Patient education materials and posters for the doctor’s office are also available.
• PSNonline https://psnonline.org/Medical%20Management%20Program/Smoking% 20Cessation/smoking_cessation_front_page.htm This site provides a copy of the sticker or stamp that includes smoking cessation in the vital signs. Several studies have shown that this can significantly improve smoking cessation counseling in the doctor’s office.