Clear-cut, unambiguous, simple physician advice to patients on the importance of smoking cessation has a significant impact on quit rates. Pharmacists are perceived as health professionals to whom patients can turn with their health problems. Patients have easy accessibility to pharmacists and consistently rate them highly in terms of professional honesty and ethical standards. The objective of the proposed study is to determine whether pharmacists' advice and patient education against smoking during routine prescription dispensing can have an impact on quit rates of smoking patients. If such a relationship exists, a collective effort mounted by practicing pharmacists during routine dispensing and patient education could yield large numbers of ex-smokers. The proposed study will involve a consortium of practicing pharmacists and will test interventions that can realistically fit into day-to-day pharmacy practice. Following a uniform, concentrated review on tobacco abuse and smoking cessation strategies, these pharmacists will perform randomly one of four study interventions on consenting patients requesting prescription service during a one-month study period: (1) administer non- intervention control questionnaires; (2) administer smoking-related questionnaires; (3) administer smoking-related questionnaires. advise patients to stop smoking, and provide patients with printed material from the Pharmacists' """"""""Helping Smokers Quit"""""""" Kit (American Pharmaceutical Association and National Cancer Institute); (4) same as group 3 with the addition of Nicorette(R) prescription and scheduled followup visits for patients without contraindications to the drug. Follow-up questionnaires will be sent to patients at three months and one year for self-reported outcome and biochemical validation will be attempted at one year in self-reported quitters.
