Tobacco Cessation Via Doctors of Chiropractic: Preliminary Results

Purpose: The specific aims of this study were to: 1) design and refine an established office-based tobacco intervention for use within chiropractic settings; and 2) develop and refine study implementation protocols, DC and patient recruitment procedures, data collection strategies, and follow-up procedures through an iterative process of engagement with participating DCs, staff, and patients.

Methods: We adapted the intervention protocol, DC training format and materials, and patient materials through the use of focus groups, interviews, and written surveys with 50 DCs and allied staff from 20 clinics in Oregon. We assessed patient outcomes at 6 weeks and 6 months post-enrollment.

Results: We recruited 155 patients who were cigarette smokers. The majority were: White (89%), female (62%), and had an income <$5,000 (63%). The tobacco use prevalence rate was 7% among participating chiropractic practices. 11.4% of patients reported 7-day abstinence at 6 weeks, 17.4% at the 6-month follow up, and 6% reported abstinence at both time points. Secondary outcomes such as reduction in tobacco use and number of quit attempts will be reported. Finally, self-reported patient receipt of intervention components, and use of alternative and allopathic cessation strategies also will be presented.

Conclusions: Doctors of Chiropractic were eager to participate in the study, and enthusiastic about the intervention protocol and materials. The study was feasible, although recruiting patients was challenging due to the low prevalence of tobacco use and repeated visits made by individual patients. Absolute cessation rates were comparable to other healthcare-based interventions.

Funded by NIDA (R21 DA021349).