Purpose:

The project is designed to test the feasibility and effectiveness of a shared smoking cessation telephone resource to which physicians may refer any of their patients who are current smokers. Our hypothesis is that physicians will do a better job of asking and advising their patients about smoking if they can delegate the assistance and follow-up to a smoking cessation resource that will call and assess current smokers, send them self-help material, offer proactive telephone support for those who are ready to quit, and provide physicians and patients information on adjunctive pharmacotherapy.

During the planning grant we will evaluate the adherence of physicians and other providers in three clinics to the AHCPR guidelines by exit interviews of patients. We will then perform structured interviews with physicians and staff in these clinics to gauge attitudes and opinions regarding a smoking cessation resource. This information will be used to design a prototype smoking cessation telephone resource as well as office systems to facilitate its use.

After implementation of the smoking cessation telephone resource and office systems for the three participating clinics, we will reassess their design and make adjustments. Following three to four months of availability, we will reassess physician adherence by exit interviews of patients. We will also examine the telephone logs for frequency of referrals, and types of interventions offered. At the conclusion of this experience, we will analyze the data and share it with the managed care organizations and the Vermont State Department of Health to determine if these institutions would support a full-scale smoking cessation telephone resource.

Objectives:

• Assess baseline adherence to AHCPR guidelines
• Develop a prototype shared smoking cessation telephone resource with physician and provider input
• Implement this resource with office systems to facilitate its use
• Assess for any change in adherence to AHCPR guidelines after implementation and experience with the resource
• Determine if a full-scale resource would be supported by the managed care organizations and the State of Vermont.