Evaluation of a structured smoking cessation program for primary care medicine

Background: Despite the fact that 9 of 10 general practitioners in Germany believe that smoking cessation is an important topic structured programs are only rarely offered to patients. Beside a lack of time and missing reimbursement, physician's limited treatment skills are frequent reasons for this observation. Therefore we aimed to develop a structured, easy to learn and time-effective smoking cessation program for the general practice. Evidence based treatment elements were combined and standardized by a step by step treatment guideline. Methods: In a non-interventional observation we tested the program's integration in the daily routines of physicians, the rate of continuous tobacco abstinence after 12 weeks and both patient's and physician's satisfaction with the program and the medication. Results: 44 physicians participated in the study. 184 patients were observed over a mean period of 12.8 weeks and were treated with an individually adapted nicotine replacement therapy for 10 weeks. At the end of treatment (12.1 weeks after the target quit date) 48.4% of the patients reported continuous abstinence. The combination of structured counseling with nicotine substitution in this program was easily implemented in doctor's practice, induced a high user satisfaction and a long usage of medication. The encouraging abstinence rate could have been influenced by selecting highly motivated patients, by offering structured and regular consultations at fixed intervals over the first weeks and by the treatment with the individually adapted nicotine substitution. Conclusion: This study shows an easy way to implement an individual and structured smoking cessation therapy in primary care medicine in Germany. Nevertheless, the results should be confirmed in larger cohorts and on a higher methodological level.