Study objective:
To test the hypotheses that physicians in private practice who receive a continuing education program (entitled “Quit for
Life”) about how to counsel smokers to quit would counsel smokers more effectively and have higher rates of long-term smoking
cessation among their patients.
Design:Randomized trial with blinded assessment of principal outcomes.
Setting:Private practices of internal medicine and family practice.
Subjects:Forty-four physicians randomly assigned to receive training (24) or serve as controls (20) and consecutive samples of smokers
visiting each physician (19.6 patients per experimental and 22.3 per control physician).
Interventions:Physicians received three hours of training about how to help smokers quit. Physicians and their office staffs were also given
self-help booklets to distribute to smokers and were urged to use a system of stickers on charts as reminders to counsel smokers
about quitting.
Measurements and main results:Based on telephone interviews with patients, physicians in the experimental group were more likely to discuss smoking with
patients who smoked (64% vs. 44%), spent more time counseling smokers about quitting (7.5 vs. 5.2 minutes), helped more smokers
set dates to quit smoking (29% vs. 5% of smokers), gave out more self-help booklets (37% vs. 9%), and were more likely to
make a follow-up appointment about quitting smoking (19% vs. 11% of those counseled) than physicians in the control group.
One year later, the rates of biochemically confirmed, long-term (≥9 months) abstinence from smoking were similar among patients
in the experimental (3.2%) and control (2.5%) groups (95% confidence interval for the 0.7% difference: −1.7 to +3.1%).
Conclusions:The authors conclude that this continuing education program substantially changed the way physicians counseled smokers, but
had little or no impact on rates of long-term smoking cessation among their patients. There is a need for more effective strategies
to help physicians help their patients to quit smoking.
Key words cigarette smoking - continuing medical education - patient-physician relationships
Supported by Grant # CA38337 from the National Cancer Institute and by the Henry J. Kaiser Foundation Faculty Fellowship in
General Internal Medicine (SRC).