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NAQC Newsroom: Tobacco Control

Ranks of Clinicians Who Intervene With Smokers Continue to Grow

Wednesday, March 10, 2010  
Clinicians across a variety of specialties are increasingly intervening with patients who smoke, according to Dr. Steven Schroeder, director of the Smoking Cessation Leadership Center (SCLC) at the University of California, San Francisco.

SCLC’s partner groups have been reporting progress in recruiting more of their members to help smokers quit, Dr. Schroeder said. For example, the American Academy of Family Physicians in a recent survey found that 80 percent of those surveyed identify smokers and 88 percent of those take further action to intervene, up from 70 percent and 40 percent, respectively. The survey found that 74 percent refer to quitlines, 26 percent refer to online services, and 26 percent refer to offsite to offsite cessation classes (down from 41 percent in the previous survey in 2007).

Another clinician group showing progress, according to Dr. Schroeder, is the American Society of Anesthesiologists. In a 2008 survey, 56 percent of respondents referred patients to the quitline, up from 5 percent in 2004. The increase could largely be attributed to a pilot project launched by ASA in 2007 to promote ask-advise-refer among 14 hospitals. Both the anesthesiologists and the family physicians created promotional campaigns that included their version of the 1-800-QUIT-NOW card.

Another successful group, California diabetes educators, reported in a 2009 survey that 91 percent of those polled reported screening clients for tobacco use at every appointment, a 14 percent increase over 2006, when 78 percent reported doing so. The 2009 survey showed that 96 percent of respondents reported that they encouraged cessation at every appointment, a 17 percent increase, and 83 percent reported referring clients to quit-smoking programs, up from 75 percent. In addition, 80 percent of diabetes educators reported referring clients to the California Smokers’ Helpline, up from 44 percent in 2006, for an 82 percent increase.

Dr. Schroeder said emergency physicians also showed significant gains. In a pilot project conducted by the American College of Emergency Physicians, a baseline was established in 2006 that 9 percent of emergency physicians documented, advised and referred smokers to a quitline and none distributed quit cards. At the end of the pilot, 16 % of emergency physicians surveyed documented, advised and referred patients who smoke to a quitline and 28 percent indicated giving a quitline card to patients who smoked.

Dr. Schroeder said clinicians in the behavioral health arena are beginning to take very seriously their role as tobacco interventionists. He said psychiatric facilities are going smoke free, and staff in particular are being urged to call quitlines. He said the American Psychiatric Nurses Association, which began its partnership with SCLC in 2008, is doing an outstanding job. APNA surveys showed that 61 percent of psychiatric nurses did brief interventions with smokers, and the group has set a target of 75 percent by 2012.

Professional organizations in the substance use disorder field are rising to the challenge of smoking cessation, Dr. Schroeder said. For example, Los Angeles County’s clinicians and peer counselors are being trained to offer brief interventions with smokers, and many are now referring smokers to the state quitline. SCLC is entering a second year of partnership with the federal Substance Abuse and Mental Health Services Administration, and many of the pioneering agencies involved in the project have become a referral source for quitlines.

For more information on these or other groups, visit the SCLC Web site at, e-mail Catherine Saucedo, or call 1-877-509-3786.

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