A smoking cessation telephone resource: feasibility and preliminary evidence on the effect on health care provider adherence to smoking cessation guidelines

Physicians have frequent opportunities to intervene with their smoking patients as approximately 70% of smokers see a physician each year. 1 Even brief counselling by a physician significantly improves the rate of smoking cessation according to meta-analyses performed by the Tobacco Use and Dependence Guideline Panel and summarised as "ask, advise, assist, and arrange follow-up" in the Agency for Health Care Policy and Research (AHCPR) guidelines. 2 Despite these evidence based recommendations, physicians identify only about half of current smokers, advise less than half, and assist and arrange follow up with a small minority. 3 There are several explanations for this disparity between physicians' knowledge and their actual behaviour including inadequate training, resource and time constraints, and lack of information on community cessation resources. Because of the non-randomised design of this pilot study, we cannot attribute improvements in provider adherence solely to the availability of the telephone resource, as provider focus groups, surveys, and training also may have increased adherence to the guidelines.