Encouraging primary care physicians to help smokers quit. A randomized, controlled trial

S. J. Cohen, G. K. Stookey, B. P. Katz, C. A. Drook, D. M. Smith

Research output: Contribution to journalArticle

135 Scopus citations


Study Objective: To increase the effect that primary care physicians have on their patients who smoke. Design: Randomized, controlled trial with 112 general internists and their patients who smoke. Patients: Sample of 1420 patients from a general medicine clinic of a city-county teaching hospital, who smoke at least one cigarette a day and were recruited regardless of their interest in quitting smoking. Interventions: Physicians were randomly assigned to one of four groups: participants who received a protocol for smoking management and a lecture on the consequences and management of smoking (control); in addition, had nicotine gum freely available to patients (gum); had stickers attached to their smokers' charts (reminder); or had both gum and reminders (both). Measurements and Main Results: The percentage of patients with a return visit at 6 months who quit smoking (alveolar carbon monoxide of less than nine parts per million) was 1.3% (control), 7.7% (gum), 7.0% (reminders), and 6.3% (both). At 1 year the percentages were 2.7%, 8.8%, 15.0%, and 9.6%, respectively. Subsequent pairwise comparisons showed that the three intervention groups were not significantly different, but that each was significantly different from the control group (P < 0.05). Physicians in all three intervention groups spent significantly more time than did the physicians in the control gorup counseling their patients about smoking. Conclusions: The availability of nicotine gum or labeling the charts of smokers can help primary care physicians increase their success rates two- to six-fold in helping patients quit smoking. If all primary care physicians used these procedures, they could help an additional 2 million smokers quit.

Original languageEnglish (US)
Pages (from-to)648-652
Number of pages5
JournalAnnals of internal medicine
Issue number8
StatePublished - Jan 1 1989

ASJC Scopus subject areas

  • Internal Medicine

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