The 130th Annual Meeting of APHA

Abstract #38889

Victor J. Stevens, PhD, Kaiser Permanente Center for Health Research, 3800 N. Interstate, Portland, OR 97227, (503) 335-6751, victor.j.stevens@kpchr.org

This project assessed implementation of tobacco control policies and cessation outcomes in nine non-profit health maintenance organizations across the United States. These HMOs provide comprehensive care to 8 ½ million individuals, including 30% minority enrollment. A survey of 41,677 randomly selected adult, primary care patients provides a description of attitudes toward smoking cessation and a progress report on the implementation of tobacco cessation services. Of the 5,724 respondents who used tobacco in the previous 12 months, 21% reported not smoking at the time of the survey. Of those smoking at the time of the survey, 27% were planning to quit in the next 30 days, and 42% reported seriously considering quitting in the next 6 months. Of those who were smoking at their last primary care visit, 75% reported being asked about tobacco use, more than 60% reported receiving advice to quit, and 28% received some form of assistance in quitting (counseling, pharmacotherapy, or combination). Of particular interest, 82% of the current smokers indicated that they felt that patients should be asked about tobacco use “often” or “at every visit”. Smokers receiving advice to quit reported greater satisfaction with their health plan than those who did not receive advice, a finding consistent with several recent studies showing higher patient satisfaction with medical care when they receive advice and assistance in quitting smoking. Results of a one-year follow-up survey of smokers and recent quitters will also be presented including descriptions of smoking cessation services received, and tobacco use outcomes.

Learning Objectives: At the end of the presentation, participants will be able to

• Describe the current level of implementation to the national tobacco treatment guidelines (5 As) in non-profit HMOs.
• Articulate the relationship between health plan tobacco control policies and the delivery of tobacco cessation services to patients.
• Develop a convincing argument for the implementation of the five As as a routine part of primary care, both to meet patient needs and to improve satisfaction with health care.

Keywords: Tobacco Control, Health Care Delivery

Presenting author's disclosure statement:
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.