Primary Care Provider-Delivered Smoking Cessation Interventions and Smoking Cessation Among Participants in the National Lung Screening Trial

New study shows intensive physician intervention increases quit rates

Tobacco users are more likely to quit when their physicians provide the “assist” and “arrange” steps within the “5 As” intervention rubric, indicates a new study published in JAMA Internal Medicine and authored by Dr. Elyse Park of Massachusetts General Hospital (MGH) Tobacco Treatment Center, with colleagues. However, relatively few U.S. smokers are currently offered this support.

Researchers examined the links between each of the clinician-delivered 5As (ask, advise, assess, assist [talk about quitting or recommend stop-smoking medications or recommend counseling], and arrange follow-up) after lung screening and smoking behavior changes. Assessment of over 3,000 participants in the National Lung Screening Trial showed that the two most intensive interventions (assist, arrange) were associated with increased quitting, while the other three (ask, advise and assess) were not.

“Our findings demonstrate the importance of clinicians’ active assistance – referring patients to counseling, prescribing a stop-smoking medication, and following up to see how they are doing – in increasing the likelihood that patients will quit smoking,” says Elyse R. Park, PhD, MPH, of the MGH Tobacco Treatment Center and lead author of the study. “While all of the participants in this study had sought screening for lung cancer and their primary care physicians were aware of that screening and its results, only half of these high-risk smokers reported that their PCPs even talked to them about how to quit smoking, and even fewer received the level of help we now know can make a critical difference.”