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Encouraging Primary Care Physicians to Help Smokers Quit: A Randomized, Controlled Trial

April 1989

Stuart J. Cohen, George K. Stookey, Barry P. Katz, Catherine A. Drook, David M. Smith


In this study, physicians with patients who smoked were randomly assigned to four groups. The first, a control group, were given a booklet and encouraged to counsel their patients to quit smoking. The second group had nicotine gum available to give to patients without cost. The third group had stickers applied to their patients’ charts, reminding them to counsel the patient to quit smoking. Finally, the fourth group had both nicotine gum available to their patients, and reminder stickers. The study found that these interventions had significant effects on quit-rates. After six months, 1.3% of the control groups patients had quit, compared to 7.7% in the gum group, 7.0% in the sticker group, and 6.3% in the gum and sticker group. After one year, 2.7% of patients in the control group had quit, compared to 8.8% in the gum group, 15.0% in the sticker group, and 9.6% in the gum and sticker group.

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Policy Implications

These results show that a great barrier to quitting smoking can be overcome with a small investment by physicians. The authors cite a Michigan survey that found only 44% of smokers had ever been told to quit by a doctor. This experiment finds that a policy as simply as free nicotine gum or even reminder stickers on a patient’s chart can enormously increase the rate of quitting.

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