COMPUTER-ASSISTED MANAGEMENT OF SMOKING CESSATION

SMOKING REMAINS THE SINGLE MOST IMPORTANT PREVENTABLE CAUSE OF DISEASE AND PREMATURE DEATH IN AMERICA. ALTHOUGH 45 MILLION AMERICANS HAVE QUIT SMOKING, AT LEAST 40 MILLION CONTINUE TO SMOKE. WHILE PHYSICIANS CAN BE EFFECTIVE IN ENCOURAGING SMOKERS TO TRY TO QUUIT, THEY ARE LESS EFFECTIVE IN FACILITATING RELAPSE PREVENTION WHICH REQUIRES AN ON-GOING EFFORT TO HELP THE PATIENTS COPE WITH THE PSYCHOLOGICAL AND PHYSIOLOGIC ASPECTS OF CESSATION. WE WILL TEST THE ACCEPTABILITY AND EFFECTIVENESS OF A COMPUTER ASSISTED SMOKING CESSATION PROGRAM CALLED HELP THAT IS DESIGNED TO EXTEND AND AMPLIFY PHYSICIANS' SMOKING CESSATION EFFORTS. THE AIMS OF THIS PHASE I PROJECT ARE TO 1) RECRUIT 200 PATIENTS WHO SMOKE FROM 10 PHYSICIAN PRACTICES INTO USING THE HELP PROGRAM; 2) EVALUATE THE PERFORMANCE OF THE HELP PROGRAM IN AN ACTUAL PRACTICE SETTING; 3) EVALUATE THE ACCEPTABILITY OF THE HELP PROGRAM TO THESE 200 PATIENTS AND 10 PHYSICIANS; AND 4) REVISE THE HELP SOFTWARE BASED ON THIS EXPERIENCE SO THAT IT CAN MANAGE A LARGE NUMBER OF SMOKERS. AFTER AGREEING TO QUIT, PATIENTS WILL BE ENROLLED FROM THEIR PHYSICIANS' OFFICES INTO THE HELP PROGRAM. ON THE QUIT DATE, THEY WILL BE TELEPHONED BY A COMPUTER-EXPERT SYSTEMS THAT WILL REINFORCE AND MONITOR THEIR QUITTING EFFORTS AND THEY WILL RECEIVE RELATED PRINT MATERIAL AND UP TO FIVE SUBSEQUENT PHONE CONTACTS. THE PATIENTS' PHYSICIANS WILL RECEIVE A COMPUTER GENERATED LETTER ON THEIR PATIENTS' PROGRESS. IF THE SYSTEM IS ACCEPTABLE TO PATIENTS, ITS EFFECTIVENESS WILL BE EVALUATED IN PHASE II.