Family physicians' utilization of a brief smoking cessation program following reinforcement contact after training: a randomized trial.

Abstract

Previous studies have examined methods of delivery of brief interventions and reinforcement contact and their effects on physicians' utilization of smoking cessation interventions. In this study the objectives were: (1) to determine the ongoing utilization by family physicians of a brief smoking cessation intervention 6 months after a training workshop and (2) to examine the effect of reinforcement contact on physician utilization. A supplementary aim was to assess point prevalence abstinence among patients identified as ready to quit smoking. This was a randomized controlled trial of family physicians (98 in the Contact and 100 in the Noncontact group). Training was conducted in a 2-hr workshop. Doctors in the Contact group received three brief telephone calls at 2 weeks, 2 months, and 4 months after training. Main outcome measures were: (1) utilization, determined by responses to a mailed questionnaire about use of the program, and (2) the number of booklets distributed by full-time doctors, collected by practice secretaries or research assistant. At 6 months 88% of physicians (93% of the Contact group and 84% of the Noncontact group, P = 0.06) were current users of the smoking cessation intervention. Full-time physicians in the Contact group distributed significantly more booklets (40.1) over 6 months than those in the Noncontact group (32.8) (P < 0.05). Twenty-one percent of patients reported not smoking at follow-up at an average of 9.9 months after intervention. Most doctors continued to use the program 6 months after training and reinforcement contact encouraged greater recruitment of patients.