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The effect of proactively identifying smokers and offering smoking cessation support in primary care populations: a cluster-randomized trial.
Addiction. 2008 Jun; 103(6):998-1006; discussion 1007-8.A

Abstract

AIMS

To establish whether proactively identifying all smokers in primary care populations and offering smoking cessation support is effective in increasing long-term abstinence from smoking.

DESIGN

Cluster randomized controlled trial.

SETTING

Twenty-four general practices in Nottinghamshire, randomized by practice to active or control intervention.

PARTICIPANTS

All adult patients registered with the practices who returned a questionnaire confirming that they were current smokers (n = 6856).

INTERVENTION

Participants were offered smoking cessation support by letter and those interested in receiving it were contacted and referred into National Health Service (NHS) stop smoking services if required.

MEASUREMENTS

Validated abstinence from smoking, use of smoking cessation services and number of quit attempts in continuing smokers at 6 months.

FINDINGS

Smokers in the intervention group were more likely than controls to report that they had used local cessation services during the study period [16.6% and 8.9%, respectively, adjusted odds ratio (OR) 2.09, 95% confidence interval (CI) 1.57-2.78], and continuing smokers (in the intervention group) were more likely to have made a quit attempt in the last 6 months (37.4% and 33.3%, respectively, adjusted OR 1.23, 95% CI 1.01-1.51). Validated point prevalence abstinence from smoking at 6 months was higher in the intervention than the control groups (3.5% and 2.5%, respectively) but the difference was not statistically significant (adjusted OR controlling for covariates: 1.64, 95% CI 0.92-2.89).

CONCLUSIONS

Proactively identifying smokers who want to quit in primary care populations, and referring them to a cessation service, increased contacts with cessation services and the number of quit attempts. We were unable to detect a significant effect on long-term cessation rates, but the study was not powered to detect the kind of difference that might be expected.

Authors+Show Affiliations

Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. rachael.murray@nottingham.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18422823

Citation

Murray, Rachael L., et al. "The Effect of Proactively Identifying Smokers and Offering Smoking Cessation Support in Primary Care Populations: a Cluster-randomized Trial." Addiction (Abingdon, England), vol. 103, no. 6, 2008, pp. 998-1006; discussion 1007-8.
Murray RL, Coleman T, Antoniak M, et al. The effect of proactively identifying smokers and offering smoking cessation support in primary care populations: a cluster-randomized trial. Addiction. 2008;103(6):998-1006; discussion 1007-8.
Murray, R. L., Coleman, T., Antoniak, M., Stocks, J., Fergus, A., Britton, J., & Lewis, S. A. (2008). The effect of proactively identifying smokers and offering smoking cessation support in primary care populations: a cluster-randomized trial. Addiction (Abingdon, England), 103(6), 998-1006; discussion 1007-8. https://doi.org/10.1111/j.1360-0443.2008.02206.x
Murray RL, et al. The Effect of Proactively Identifying Smokers and Offering Smoking Cessation Support in Primary Care Populations: a Cluster-randomized Trial. Addiction. 2008;103(6):998-1006; discussion 1007-8. PubMed PMID: 18422823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of proactively identifying smokers and offering smoking cessation support in primary care populations: a cluster-randomized trial. AU - Murray,Rachael L, AU - Coleman,Timothy, AU - Antoniak,Marilyn, AU - Stocks,Joanne, AU - Fergus,Alexia, AU - Britton,John, AU - Lewis,Sarah A, Y1 - 2008/04/16/ PY - 2008/4/22/pubmed PY - 2008/8/15/medline PY - 2008/4/22/entrez SP - 998-1006; discussion 1007-8 JF - Addiction (Abingdon, England) JO - Addiction VL - 103 IS - 6 N2 - AIMS: To establish whether proactively identifying all smokers in primary care populations and offering smoking cessation support is effective in increasing long-term abstinence from smoking. DESIGN: Cluster randomized controlled trial. SETTING: Twenty-four general practices in Nottinghamshire, randomized by practice to active or control intervention. PARTICIPANTS: All adult patients registered with the practices who returned a questionnaire confirming that they were current smokers (n = 6856). INTERVENTION: Participants were offered smoking cessation support by letter and those interested in receiving it were contacted and referred into National Health Service (NHS) stop smoking services if required. MEASUREMENTS: Validated abstinence from smoking, use of smoking cessation services and number of quit attempts in continuing smokers at 6 months. FINDINGS: Smokers in the intervention group were more likely than controls to report that they had used local cessation services during the study period [16.6% and 8.9%, respectively, adjusted odds ratio (OR) 2.09, 95% confidence interval (CI) 1.57-2.78], and continuing smokers (in the intervention group) were more likely to have made a quit attempt in the last 6 months (37.4% and 33.3%, respectively, adjusted OR 1.23, 95% CI 1.01-1.51). Validated point prevalence abstinence from smoking at 6 months was higher in the intervention than the control groups (3.5% and 2.5%, respectively) but the difference was not statistically significant (adjusted OR controlling for covariates: 1.64, 95% CI 0.92-2.89). CONCLUSIONS: Proactively identifying smokers who want to quit in primary care populations, and referring them to a cessation service, increased contacts with cessation services and the number of quit attempts. We were unable to detect a significant effect on long-term cessation rates, but the study was not powered to detect the kind of difference that might be expected. SN - 0965-2140 UR - https://www.unboundmedicine.com/medline/citation/18422823/The_effect_of_proactively_identifying_smokers_and_offering_smoking_cessation_support_in_primary_care_populations:_a_cluster_randomized_trial_ L2 - https://doi.org/10.1111/j.1360-0443.2008.02206.x DB - PRIME DP - Unbound Medicine ER -