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Cited by 258Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesHealth Promotion and Cardiovascular Prevention

Increasing the efficacy of physician-delivered smoking interventions: A randomized clinical trial

Ockene, Judith K., Kristeller, Jean, Goldberg, Robert, Amick, Terrence L., Pekow, Penelope S., Hosmer, David, Quirk, Mark, Kalan, Kathryn·1991·Journal of General Internal Medicine
DOI 10.1007/bf02599381
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Abstract

Objective To assess the relative impacts of three physician-delivered smoking interventions in combination with follow-up contact from behavioral counselors.Design Randomized controlled trial with pre- post measures of smoking rates. This paper reports six-month outcome data.Setting Participants were recruited from among patients seen by 196 medical and family practice residents in five primary care clinics.Participants Participants were 1,286 patients out of 1,946 eligible smokers approached. The patient group was 57% female and 91% white, had an average age of 35 years, and smoked, on average, slightly over one pack per day.Intervention Physicians were trained to provide each of three interventions: advice only, brief patient-centered counseling, and counseling plus prescription of nicotine-containing gum (Nicorette). Half the patients received follow-up in the form of telephone counseling at three-monthly intervals from behavioral counselors.Measurements and main results Changes in smoking behaviors were assessed by telephone interview six months after physician intervention. The differences in one-week point prevalence cessation rates among the physician interventions were significant (p less than 0.01): advice only, 9.1%; counseling, 11.9%; counseling plus gum, 17.4%; with no effect for telephone counseling. The time elapsed from physician encounter to initial quitting and the length of that period of abstinence also showed significant benefit of the counseling interventions. Patients receiving physician counseling were much more likely than those not receiving counseling to rate their physician as very helpful (p less than 0.001). Multiple regression analyses are also reported.Conclusion Smoking intervention counseling provided by physicians is well received by patients and significantly increases the likelihood of cessation at six months, an effect that is augmented by the prescription of nicotine-containing gum, when compared with physician-delivered advice. Follow-up telephone counseling does not contribute significantly to smoking behavior changes.

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  • Findings confirm modest but significant impacts of brief physician advice or intervention on smoking cessation, improved dietary quality, and increased physical activity.

    “Findings confirm modest but significant impacts of brief physician advice or intervention on smoking cessation, improved dietary quality, and increased physical activity.14,15,19,22–27”

    From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [25]

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Authors
Ockene, J. K., Kristeller, J., Goldberg, R., Amick, T. L., Pekow, P. S., Hosmer, D., Quirk, M., & Kalan, K.
Affiliations
  • University of Massachusetts Chan Medical School (US)
  • University of Massachusetts Amherst (US)
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
1991-01
Volume
6
Issue
1
Pages
1-8
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1007/bf02599381
OpenAlex
W2016540408
Cited by
258
References
35
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2022: 2 · 2021: 3 · 2019: 5 · 2018: 3 · 2017: 1 · 2016: 3 · 2015: 1 · 2014: 4 · 2013: 5 · 2012: 7
FWCI
8.46
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship@UMassChan (submittedVersion)
  • ScholarWorks@UMassAmherst (University of Massachusetts Amherst) (submittedVersion)
Funders
  • National Institutes of Health (5r01ca038360-05)
  • National Cancer Institute (CA38360)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
smoking cessation, brief counseling, nicotine gum, telephone counseling, follow-up contact, primary care, smoking cessation counseling, patient satisfaction with physician, abstinence duration
MeSH terms
Smoking Prevention, Adult, Behavior Therapy, Chewing Gum, Counseling, Female, Follow-Up Studies, Humans, Internship and Residency, Male, Nicotine, Outpatient Clinics, Hospital, Physician-Patient Relations, Polymethacrylic Acids, Polyvinyls, Regression Analysis, Telephone, Tobacco Use Cessation Devices

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