Purpose:

To study ways to encourage tobacco users to identify their tobacco use status to their primary care providers and to solicit help in making a cessation attempt.

Objectives:

This 12-month pilot-study seeks to examine ways to encourage tobacco users to identify their tobacco use status to their primary care providers and to have a discussion about tobacco use cessation with them. Phase I involves a focus group of 8 to 12 adult tobacco users to identify the conditions and incentives that would encourage their initiation of tobacco use identification and discussion. Phase II involves adult tobacco users who are enrollees of QualChoice of North Carolina, Inc. (QC) and are seen in a general internal medicine practice. A sample of 500 QC patients will be mailed a Health Risk Appraisal (HRA) to determine tobacco use status and pertinent interactions with their doctors. Tobacco users will be randomly assigned to either: 1) continue as usual, 2) receive a mailing encouraging them to discuss tobacco use with their doctors, 3) same as 2 but with incentives for doing so. The hypothesis is that there will be differences among the three groups in identifying their tobacco use status, having a discussion about cessation and receiving advice and support from their doctors. Outcomes will be assessed through an endpoint medical record review and by responses to the HRAs given at baseline and endpoint.