This is a proposal for a randomized clinical trial of five different physician antismoking interventions, all of which are designed to fit readily into the context of outpatient medical practice. Participants will be 2000 new adult patients being seen for the first time by their study physician. The study physicians will be residents in clinical training in the Departments of General Medicine and Family and Community Medicine who are seeing patients in four medical and family practice clinics associated with the Medical School. It is estimated that 75 residents will participate over the course of the study. A multifaceted training program has been developed which will fit conveniently into the regular residency training procedures. All residents will be trained to provide all five of the different interventions, and specific protocols will be used to guide residents in the appropriate treatment of individual patients according to the condition to which that patient is randomly assigned. The basic experimental design is a 2 x 2 design with two different intensities of physician intervention and two different intensities of therapeutic followup; the fifth experimental condition results from adding nicotine chewing gum to the maximal intervention/maximal folloup condition. There will be 400 patients in each of the five conditions. All will be followed for two years via phone contacts at months 3, 6, 12, 18 and 24 post-intervention. All patients reporting smoking abstinence at 3, 12 or 24 months will be seen in person for collection of a salivary sample for cotinine analysis for objective determination of smoking status. Extensive psychosocial data will be collected to be used in assessing patient characteristics and experiences associated with successful versus unsuccessful smoking outcomes.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA038360-05
Application #
3176475
Study Section
(SSS)
Project Start
1984-09-26
Project End
1989-08-31
Budget Start
1988-09-01
Budget End
1989-08-31
Support Year
5
Fiscal Year
1988
Total Cost
Indirect Cost
Name
University of Massachusetts Medical School Worcester
Department
Type
Schools of Medicine
DUNS #
660735098
City
Worcester
State
MA
Country
United States
Zip Code
01655
Ockene, J K (1999) Primary care-based smoking interventions. Nicotine Tob Res 1 Suppl 2:S189-93;discussion S207-10
Rosal, M C; Ockene, J K; Hurley, T G et al. (1998) Effectiveness of nicotine-containing gum in the Physician-Delivered Smoking Intervention Study. Prev Med 27:262-7
Ockene, J K; Kristeller, J; Pbert, L et al. (1994) The physician-delivered smoking intervention project: can short-term interventions produce long-term effects for a general outpatient population? Health Psychol 13:278-81
Goldberg, R J; Ockene, J K; Kristeller, J et al. (1993) Factors associated with heavy smoking among men and women: the physician-delivered smoking intervention project. Am Heart J 125:818-23
Hebert, J R; Kristeller, J; Ockene, J K et al. (1992) Patient characteristics and the effect of three physician-delivered smoking interventions. Prev Med 21:557-73
Ockene, J K; Kristeller, J; Goldberg, R et al. (1991) Increasing the efficacy of physician-delivered smoking interventions: a randomized clinical trial. J Gen Intern Med 6:1-8
Ockene, J K; Quirk, M E; Goldberg, R J et al. (1988) A residents' training program for the development of smoking intervention skills. Arch Intern Med 148:1039-45