Awakening the sleeping giant: mainstreaming efforts to decrease tobacco use in an HMO

HMO Pract. 1995 Sep;9(3):138-43.


Group Health Cooperative (GHC) of Puget Sound is developing, within a framework of quality improvement, a comprehensive population-based approach to decreasing the prevalence of tobacco use. Broad organizational support has been obtained, centralized support is being integrated with clinic-level activity, local ownership of outcomes is encouraged with empowerment of health care teams, and support for community and policy-based activities is being provided. GHC's smoking prevalence has decreased from 25% to 15.5% over the past decade, while the state of Washington's prevalence declined from 23.7% to 21.8%.

MeSH terms

  • Community Health Planning / organization & administration*
  • Health Education
  • Health Maintenance Organizations / organization & administration
  • Health Maintenance Organizations / standards*
  • Health Promotion / organization & administration*
  • Humans
  • Mainstreaming, Education
  • Nicotine / therapeutic use
  • Outcome Assessment, Health Care
  • Prevalence
  • Smoking Cessation / methods
  • Smoking Cessation / statistics & numerical data*
  • Smoking Prevention*
  • Washington / epidemiology


  • Nicotine