Computer Support for Pharmacy-Based Smoking Cessation

DESCRIPTION (provided by applicant): Public health experts have identified smoking cessation as the most cost-effective tobacco control strategy. Smoking cessation support delivered by health care professionals can be a highly effective means of reaching out proactively to smokers and helping them quit. Pharmacists are in an ideal position to advise and influence smokers regarding nicotine related therapy and to counsel smokers. Yet, pharmacists experience significant barriers to providing consistent, high-quality supports to smokers, including; time limitations, lack of training in effective counseling techniques and lack of reimbursement for counseling smokers (Ossip-Klein et al., 2000). This software system will provide basic training in pharmacy based smoking cessation counseling, save pharmacist time by conducting relevant assessments and provide high quality feedback to the smoker. The goal of this Phase II application is to finalize development and test the efficacy of the computer-based expert system ("Exper_Quit") developed in our Phase I project. Specifically, our goals are: 1) to increase the frequency with which pharmacists address smoking cessation in their interaction with customers, and 2) to increase the number of smokers who will be successful when making a quit attempt. The first six months of the project will be devoted to finalizing programming, coding, testing and writing content for the additional assessment and feedback components. Efficacy of the system will be tested at a HMO-based pharmacy. Exit interview data will be collected from smokers to assess the extent of pharmacist counseling for smoking with no intervention (observation only: OBS). Pharmacists will then be trained in providing smoking cessation counseling. Two additional groups of smokers will recruited by pharmacists and randomly assigned to either the TEST or CONTROL conditions. TEST participants will complete assessments, receive personalized feedback and a matching pharmacist report and be counseled by the pharmacist. These subjects will return in 1 month for a follow-up Exper_Quit assessment and to receive feedback on their progress. CONTROL participants will complete the baseline assessment but will not receive feedback and no pharmacist report will be printed. Exit interviews will document the extent of pharmacist counseling. All subjects will complete 2 and 6 month follow up assessments. Cessation (7 day point-prevalence abstinence) will be verified by saliva cotinine at month 6.