New approach helps more smokers connect to tobacco treatment

Smoking remains the leading cause of preventable illness and death in the United States, so the health benefits of quitting are substantial. The majority of smokers are motivated to quit and more than half of all smokers attempt to quit each year. Sadly, only a small minority succeeds.

Researchers at MD Anderson are working to change this by changing the culture of how they reach self-admitted smokers with a new approach aimed at connecting through family practice clinics.

A collaboration involving MD Anderson researchers, the Texas Quitline and Kelsey-Seybold Clinics targeted smokers and their enrollment in tobacco treatment programs by directly connecting smokers with cessation quit lines.

Ask-Advise-Connect Ask-Advise-Connect, a new approach designed to efficiently link smokers with cessation treatment, showed a significant increase in tobacco treatment enrollment by smokers who were directly contacted by quit line staff, according to results published online today in JAMA Internal Medicine.

JAMA published a video interview February 27 with study principal investigator Jennifer Irvin Vidrine, Ph.D., associate professor in the Department of Health Disparities Research at MD Anderson. The nine-month study randomized five clinics to the Ask-Advise-Connect approach where vocational nurses and medical assistants collected tobacco-use information from self-identified smokers and recorded it in their electronic health record (EHR). Information was then delivered to MD Anderson researchers and the Texas Quitline. Quit line staff followed up with smokers directly via phone.

The 13-fold increase in smokers signing up for tobacco treatment through the Ask-Advise-Connect approach was compared to the control group of five Kelsey Seybold clinics that administered the Ask-Advise-Refer method - an approach that relies on smokers to contact the quit line on their own.

"These findings indicate that smokers in health care settings are interested in smoking cessation treatment," Vidrine says. "The EHR-based approach not only addresses barriers to connecting smokers with treatment programs, but dramatically enhances the likelihood that smokers will enroll in cessation treatment."

More than 32,000 unique patients' information was recorded in the EHR and 3,663 patients reported being current smokers. Study results: 7.8 percent of smokers identified at Ask-Advise-Connect clinics enrolled in treatment with the quit line compared to 0.6% of smokers identified at Ask-Advise-Refer clinics. Vidrine says this is the highest rate of tobacco cessation treatment enrollment reported to date.

Vidrine is working on another randomized trial comparing the two different approaches in a large health care system that provides care to low socioeconomic status and predominately minority patients.

Additional information Read the MD Anderson News Release Read the Publication