Physician Referral to Quitlines

Overview

Telephone counseling for tobacco cessation has been proven to be an effective way to reduce tobacco use.  Most tobacco users in the United States and Canada have access to telephone counseling. Public health agencies have worked hard to inform smokers of the availability of tobacco quitlines. It may be useful to make use of primary care settings by encouraging physicians to refer patients to a quitline; however this strategy has not been evaluated. This study describes a method of linking patients in Oregon clinics to the Oregon Tobacco Quitline by training physicians on the 5A’s model of brief intervention and providing the physicians with referral materials for the quitline.

Methods

Two methods (fax referral and providing a brochure) were provided to participating physicians to connect their patients to a state-level quitline in Oregon. The study population included 175 providers (physicians, residents, nurse practitioners, and physician assistants) in 17 primary care clinics and two teaching clinics.  Physician trainers held 30-minute training sessions in all clinics to review the 5A’s evidence-based cessation strategy (ask, advise, assess, assist, and arrange). Provider referral rates and the costs of development, implementation, and training were measured.  

Results

Nineteen clinics participated in the study. Between October 2002 and October 2003, a total of 103,597 unique patients visited a study clinic. Data on tobacco use was collected for 91% of the patients. 15,662 (15%) were current tobacco users. The Oregon Quit Line received a total of 745 referrals (4.8%), including both fax and brochure groups. 496 (67%) were referred by fax.  The quit line was able to successfully contact 292 (59%) of the fax referrals, and of those 263 (90%) accepted a one-time tobacco-cessation intervention from a quit-line counselor.  In the first year of the program, the cost ranged from $15 to $22 for each patient who was connected to the quitline.  In the years after the cost dropped to $4 to $6 per patient.

Conclusions

Creating a system that assists physicians with connecting patients with a state-level quit line is a viable strategy that uses minimal resources and can be cost effective. Dr. Bentz encourages all tobacco quit lines to consider training physicians to connect patients with available quit lines as a useful strategy to increase utilization by tobacco users.

• Press Room
  • Press Release Archive
  • Print Article Archive
  • Web Article Archive
• Research Library
• CBS Services
• Our Clients
• Leadership Team
• Employment
  • Job Postings