Objective: To describe the design, implementation, baseline data, and feasibility of establishing a disease management program for smoking cessation in rural primary care. Method: The study is a randomized clinical trial evaluating a disease management program for smoking cessation. The intervention combined pharmacotherapy, telephone counseling, and physician feedback, and repeated intervention over two years. The program began in 2004 and was implemented in 50 primary care clinics across the State of Kansas. Results: Of eligible patients, 73% were interested in study participation. 750 enrolled participants were predominantly Caucasian, female, employed, and averaged 47.2 years of age (SD = 13.1). In addition to smoking, 427 (57%) had at least one additional major risk factor for cardiovascular disease (diabetes, hypertension, high cholesterol, heart disease or stroke). Participants smoked on average 23.7 (SD = 10.4) cigarettes per day, were contemplating (61%) or preparing to quit (30%), were highly motivated and confident of their ability to quit smoking, and reported seeing their physicians multiple times in the past twelve months (Median = 3.50; Mean = 5.48; SD = 6.58). Conclusion: Initial findings demonstrate the willingness of patients to enroll in a two-year disease management program to address nicotine dependence, even among patients not ready to make a quit attempt. These findings support the feasibility of identifying and enrolling rural smokers within the primary care setting.
Bibliographical noteFunding Information:
This research was supported by grant number CA 1102390 from the National Cancer Institute at the National Institutes of Health. The authors would like to thank Carla Berg, Genevieve Casey, Olivia Chang, Andrea Elyacher, Tresza Hutcheson, Shawn Jeffries, Terri Tapp and the KAN-QUIT associates for their efforts on this project. We are also grateful to the volunteers who participated in this research.
- Disease management
- Nicotine dependence
- Primary care
- Rural health
- Smoking cessation
- Tobacco use