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NAQC Newsroom: Research

Ask-Advise-Connect: A New Approach to Smoking Treatment Delivery in Health Care Settings

Wednesday, March 13, 2013  
Posted by: Natalia Gromov
Vidrine JI, Shete S, Cao Y, Greisinger A, Harmonson P, Sharp B, Miles L, Zbikowski SM, Wetter DW. JAMA Intern Med. Published online February 25, 2013.

This study evaluated a new approach to Ask-Advise-Refer programs (the first 2 of the 5A’s, with referral to quitlines). Ask-Advise-Connect (AAC) was designed to address barriers to linking smokers with treatment that typically result in low rates of primary care referrals to quitlines, and most referred smokers failing to call quitlines for assistance. Five clinics within a metropolitan area were randomized to the AAC intervention condition, and five were randomized to the AAR (control) condition. In the AAC clinics, the names and telephone numbers of referred smokers were sent to the quitline daily, and patients were called by the quitline within 48 hours. In the AAR clinics, patients were given a quitline referral card and encouraged to call the quitline on their own. Results showed that 7.8% of all identified smokers enrolled in quitline counseling in the AAC clinics, while 0.6% enrolled in the AAR clinics (p<.001), representing a 13-fold increase in the proportion of smokers enrolling in treatment. The authors conclude that the system changes implemented in the AAC approach have tremendous potential to reduce tobacco-related morbidity and mortality, and could be adopted broadly by other health systems.

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