4096.0: Tuesday, October 23, 2001 - 12:40 PM

Abstract #25812

A review of effectiveness of smoking cessation interventions: Implications for Medicare

Paul G. Shekelle, MD, PhD1, Sally A. Morton, PhD1, Margaret Maglione, MPP1, Walter Mojica, MD, MPH1, and Erin Stone, MD2. (1) RAND, 1700 Main St., Santa Monica, CA 90407, (2) Kaiser Permanente Medical Center, 5601 De Soto Ave., Woodland Hills, CA 91365, 818 719-3392, Erin.G.Stone@kp.org

As part of a HCFA initiative on preventive health for seniors, RAND undertook an extensive review of the evidence on smoking cessation interventions. Existing research was identified from the Cochrane Collaboration Tobacco Group database, the draft Public Health Service (PHS) clinical practice guideline, ten previously completed systematic reviews, and a library search of Medline, PsychLit, Dissertation Abstracts and Social Sciences Index. The interventions used to promote smoking cessation fell into the following broad categories: self-help, counseling, pharmacotherapy, education, financial incentives, and media campaigns. RAND found that individual, telephone, and group counseling were all effective, with individual counseling possibly being most effective. There was consistent evidence from multiple analyses that a greater intensity of counseling yields higher smoking cessation rates. In addition, nicotine replacement therapy (NRT) was found to be highly effective. The only study reporting on health insurance and smoking cessation interventions found that coverage of 100% for both counseling and NRT produced the greatest number of quitters in a population. The evidence was presented to an expert panel who then made recommendations for developing a smoking cessation demonstration program for elderly Medicare beneficiaries. The national demonstration project, to take place in seven states, will include pharmacotherapy, physician visits, and a telephone quitline.

Learning Objectives: N/A

Keywords: Tobacco Control,

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, .0 kb)

The 129th Annual Meeting of APHA