Smoking is the leading preventable cause of cancer mortality in the US. Despite its profound health and economic costs, smoking treatment is infrequently provided in healthcare settings, and when provided, it is not sufficiently effective. To address this, Project 1 will develop and evaluate more efficient electronic health record (EHR) methods to identify smokers and engage them in evidence-based treatment. Specifically, Project 1 will develop and test new EHR enhancements and associated healthcare practices that are designed to efficiently identify smokers and recruit them into a chronic care treatment for smoking (which will be developed and evaluated in Projects 2-4). The EHR enhancements will include: 1) smoker identification and documentation aids, 2) a """"""""Smoker Registry"""""""" (which stores relevant data on smokers and facilitates tracking their smoking status over time), 3) a 1-click system to refer smokers to the chronic care treatment for smoking, 4) a closed-loop function to provide EHR feedback to clinicians on the outcomes of their referrals, and 5) communications resources to inform smokers of treatment options and to increase their recruitment into treatment. The effects of the EHR-based enhancements and the chronic care smoking treatment will be evaluated with a multiple baseline design involving 18 primary care clinics in three healthcare systems in Wisconsin;all participants for Projects 2-4 will be recruited from these clinics. In addition, a Project 1 Substudy will use a mixed-methods research strategy (comprising both questionnaires and qualitative interviews) to identify clinic-level obstacles to the effective implementation of the EHR-based smoker recruitment system. This highly innovative research will evaluate the impact of an integrated set of EHR enhancementscoupled with a chronic care approach to smoking treatmenton smoker identification, and smoking treatment referral and engagement. In addition, this research will explore factors that influence the use of EHR-based enhancements in clinics. In sum, this research will develop a set of EHR-based health system enhancements that increase both the adoption of chronic care treatment by healthcare systems and smokers'engagement in that treatment.

Public Health Relevance

Smoking is the leading preventable cause of illness and death in the US, including cancer deaths, yet few smokers visiting clinics receive highly effective treatments to help them to quit. This research is aimed at developing new electronic health record (EHR)-based methods to better engage smokers in smoking treatment when they make healthcare visits, thereby reducing their risk of smoking-related disease.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Program Projects (P01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1-RPRB-0 (O2))
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Wisconsin Madison
United States
Zip Code
Loh, Wei-Yin; Fu, Haoda; Man, Michael et al. (2016) Identification of subgroups with differential treatment effects for longitudinal and multiresponse variables. Stat Med 35:4837-4855
Piper, Megan E; Fiore, Michael C; Smith, Stevens S et al. (2016) Identifying effective intervention components for smoking cessation: a factorial screening experiment. Addiction 111:129-41
Collins, Linda M; Kugler, Kari C; Gwadz, Marya Viorst (2016) Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS. AIDS Behav 20 Suppl 1:S197-214
Schlam, Tanya R; Fiore, Michael C; Smith, Stevens S et al. (2016) Comparative effectiveness of intervention components for producing long-term abstinence from smoking: a factorial screening experiment. Addiction 111:142-55
Adsit, Robert; Wisinski, Kari; Mattison, Ryan et al. (2016) A Survey of Baseline Tobacco Cessation Clinical Practices and Receptivity to Academic Detailing. WMJ 115:143-6
Watkins, Edward; Newbold, Alexandra; Tester-Jones, Michelle et al. (2016) Implementing multifactorial psychotherapy research in online virtual environments (IMPROVE-2): study protocol for a phase III trial of the MOST randomized component selection method for internet cognitive-behavioural therapy for depression. BMC Psychiatry 16:345
Baker, Timothy B; Collins, Linda M; Mermelstein, Robin et al. (2016) Enhancing the effectiveness of smoking treatment research: conceptual bases and progress. Addiction 111:107-16
Cook, Jessica W; Collins, Linda M; Fiore, Michael C et al. (2016) Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit: a factorial screening experiment. Addiction 111:117-28
Fiore, Michael C; Jorenby, Douglas E; Baker, Timothy B (2016) Don't Wait for COPD to Treat Tobacco Use. Chest 149:617-8
McCarthy, Danielle E; Ebssa, Lemma; Witkiewitz, Katie et al. (2015) Paths to tobacco abstinence: A repeated-measures latent class analysis. J Consult Clin Psychol 83:696-708

Showing the most recent 10 out of 29 publications