This planning grant designed and evaluated the feasibility of implementing changes in the smoker identification system and referral to cessation services within The Wellness Plan (TWP).  Four sites of this managed care organization based in Detroit and serving a primarily African-American, Medicaid-eligible population, participated in this study. 

System changes included:  “vital signs” stamp to indicate smoking status and an electronic encounter data form to identify smokers.  Five months after the system changes had been implemented, chart reviews indicated that over 90% of patients had documentation in the chart indicating they had been asked about their current smoking status.  Exit interviews of patients confirmed the findings from the chart review.  Nine months after implementation there were electronic encounter data forms completed for 90% of patients seen in that time period.  Other system changes included providing nicotine replacement therapy (NRT) as a covered benefit and establishing a smoker resource center on site that provided patients with a variety of resources to aid in cessation.  282 smokers enrolled at the smokers’ resource center over the course of the study.  57% of these smokers chose telephone counseling, 7% chose print-based counseling, 29% selected self help materials, and 7% opted for other group counseling.  Preliminary follow-up data (n=32) showed that 50% of subjects reported having successfully quit smoking for at least 7 days. 

These system changes assisted the staff at TWP to consistently identify smokers.  While only a small number of smokers used the cessation services available, the services are in place for those ready and willing to make a quit attempt.  

For more information, contact:

Robert Burack, M.D., M.P.H.
4201 St. Antoine, Pod 5C
Detroit, MI 48202