According to a study just published in
Preventive Medicine, 68 percent of smokers who were offered free cessation treatment at their regular clinics took advantage of the invitation. These results contradict previous research that suggested that smokers are not eager for intervention by their physicians. When offered a choice of treatment, 75 percent of the participants in the study selected counseling in conjunction with
nicotine patch medication.
This study, conducted in primary care clinics in Madison and Milwaukee, Wis., by researchers at the University of Wisconsin Center for Tobacco Research and Intervention (CTRI) and the University of Wisconsin Medical School-Milwaukee was designed to assess the acceptance, use and effectiveness of free smoking cessation treatments integrated into routine primary care. With 70 percent of smokers visiting their primary care physicians at least once a year, health care clinics are well-suited sites for tobacco cessation treatment.
"Lack of interest among patients has been cited as a reason for not offering cessation help to smokers," said Michael Fiore, lead researcher and CTRI director. "This study demonstrated convincingly that smokers are interested in getting help to quit. In fact, over two-thirds said, 'Yes' to offers of cessation treatment even when that was not the reason for their doctor visit. And, when offered a choice of treatment, they preferred the most intensive treatment available."
The study was designed to reduce barriers to treatment use by offering free, convenient treatment. Medical assistants at diverse clinics invited smokers to participate in a treatment program involving free nicotine replacement therapy and possible counseling. Recruitment was integrated into the regular clinic routine. Participants simply had to say "yes" when asked if they were interested in receiving cessation treatment to begin enrollment. Participants who enrolled in treatment were assigned to one of two conditions-a "random" condition or a "free choice" condition. In the "random" condition, they were randomly assigned to one of the following treatments-the nicotine patch, the patch plus the Committed Quitters (CQ) program (self-help materials and telephone counseling provided by the patch manufacturer) or the patch plus CQ plus individual counseling. In the "free choice" condition, smokers themselves selected among these three treatment options.
"We conclude from this study that smokers are willing to engage in cessation treatment," Fiore says. "Lack of easy access to free, convenient care, rather than lack of interest, may be keeping the millions of smokers who want to quit from doing so. This study provides a model for a tobacco cessation treatment referral program for primary care clinics which could be used anywhere in the country."
Of the 4,174 smokers who were invited, 68 percent accepted the invitation for treatment. Those smokers who tend to have more trouble quitting--women and African American smokers--were especially likely to accept treatment.
Of those who accepted, passed the screening, and were assigned to the "free choice" condition, 75 percent elected to receive treatment that included counseling. More than 40 percent selected face-to-face counseling.