Use of the Vital Sign Stamp as a Systematic Screening Tool to Promote Smoking Cessation

Piper, Megan E.; Fiore, Michael C.; Smith, Stevens S.; Jorenby, Douglas E.; Wilson, Jackie R.; Zehner, Mark E.; Baker, Timothy B.
June 2003
Mayo Clinic Proceedings;Jun2003, Vol. 78 Issue 6, p716
Academic Journal
• Objectives: To examine the ability of a simple systemwide screening assessment tool, an expanded vital sign stamp, to increase rates of smoker identification, physician advice to quit smoking, and physician assistance in quitting and abstinence rates. • Participants and Methods: This study is a pretest, post-test design in which 5 primary health care clinics were randomly assigned to either the intervention condition, which received the vital sign stamp, or the control condition. Participants (N=9439) were surveyed by using exit interviews at the 5 clinics, both before and after the vital sign intervention was implemented. Participants who were identified as smokers were then contacted 1 year later for follow-up. The study began in February 1995, and all follow-up visits were completed by December 1998. • Results: Implementation of the vital sign stamp significantly increased the rates at which physicians asked participants about their smoking status (17.2% vs 7.5%). However, the rates of physicians advising smokers to quit, assisting them in quitting, and arranging follow-up either stayed constant or decreased. The number of quit attempts and abstinence rates also stayed constant. • Conclusion: A simple system-wide screening assessment tool, while effective in identifying more tobacco users, did not increase the rates at which physicians advised or assisted smokers to quit. Further system-wide changes may be needed to ensure that effective tobacco-dependence treatments are given to smokers.


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