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. Pharmacy clients typically see a pharmacist on a regular basis and regard pharmacists as highly valued caregivers. (McAneny L. 1999). Pharmacists are in a good position to help smokers quit and can provide important counseling supports as well as guidance in using nicotine replacement products. However, pharmacists often do not have the time or other resources to provide these important supports. Computer software programs (expert systems) have been used successfully to assist healthcare workers in providing smoking cessation counseling and supports (Prochaska et al., 1993; Strecher et al., 1994; Velicer et al., 1994). These systems provide standardized assessments and counseling feedback to smokers while reducing the burden to healthcare workers and clinical staff (Bock & Bock, 2001; Bock et al., 1999). The goal of this proposal is to develop a practical, inexpensive, easily delivered, evidence-based intervention to assist pharmacists in providing smoking cessation help to under-served adult smokers. The intervention will utilize an expert system software program customized for delivery through community health care pharmacies. It will provide individual assessment and tailored, real-time feedback reports to participants and pharmacist reports, which outline key areas for patient improvement and counseling suggestions for the pharmacist. This program will provide assessment of smokers' readiness to quit smoking (motivation), nicotine dependence, potential triggers, perceived benefits and barriers to quitting. Feedback reports to the patient will identify areas needing improvement, provide positive reinforcement of the patient's strengths, and highlight areas that need improvement and provide counseling suggestions for quitting smoking. All reports will be available in both English and Spanish. System logic is derived from evidence-based behavioral models that hold promise for helping individuals quit smoking (Hudmon et al., 1995; Prochaska et al., 1992). In Phase I, we will develop the software program and evaluate system acceptability using a pre-post design in a single group of subjects (N=50).