Integrating smoking cessation treatment into primary care: an effectiveness study

Prev Med. 2004 Apr;38(4):412-20. doi: 10.1016/j.ypmed.2003.11.002.


Background: Lack of interest has been cited as a reason not to offer cessation assistance to smokers, but research suggests that smokers accept treatments offered proactively. This study assessed acceptability, utilization, and effectiveness of free smoking cessation treatment among diverse primary care patients.

Method: Medical assistants invited 4174 adult smokers to participate. Enrollees (1869) self-selected or were assigned to receive free nicotine patch therapy alone or in combination with the Committed Quitters(R) program, and for some, individual counseling.

Results: In nearly 68% of cases, patients accepted a treatment invitation; 77% of eligible smokers enrolled; 85% of these picked up free patches. Given a choice of treatments, 75% of participants elected a psychosocial treatment in addition to patch therapy. Thirteen percent of treatment initiators achieved biochemically confirmed 7-day point-prevalence abstinence at 1 year, with no significant treatment effects. Minority patients showed greater initial interest but less utilization did than White patients.

Conclusions: Free, readily accessible smoking cessation treatment offered in primary care settings was accepted and used by the majority of unselected smokers of diverse racial/ethnic origins. Psychosocial treatment components did not significantly increase abstinence rates. Barriers, rather than lack of interest, may keep minority smokers from using cessation treatments.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Directive Counseling / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nicotine / administration & dosage*
  • Nicotinic Agonists / administration & dosage*
  • Patient Acceptance of Health Care / ethnology
  • Patient Acceptance of Health Care / psychology*
  • Primary Health Care*
  • Smoking Cessation / ethnology
  • Smoking Cessation / methods*
  • Smoking Cessation / psychology
  • Treatment Outcome


  • Nicotinic Agonists
  • Nicotine