The aim of this project is to develop and test an effective, commercially viable, self-help program for treating tobacco dependence in health caresettings. Through evaluations with physicians and their staffs from hospitals and HMOs, a replicable training and counseling protocol with intervention aids will be designed to augment the NCI manual for physicians on "How to Help Your Patients Stop Smoking." The Free and Clear self-help nicotine fading guide, developed and evaluated in an ongoing NCI-funded clinical trial, combined with counselor-initiated "Quitline" calls found to boost longterm quit rates by 50 percent, will form the nucleus of the intervention. A novel, "instant" computerized assessment and triage instrument will be tested. The protocols, materials, and systems will be pretested, then the intervention strategy will be pilot-tested with about 50 smokers under the direction of 5 to 10 physicians in four health care facilities. Evaluations will focus on feasibility, provider and patient acceptance, and overall cost effectiveness. Evaluations will be carried out by questionnaires and through followup interviews with patients.Awardee's statement of the potential commercial applications of the research:Hospital and HMO professionals who are in contact with patients have an opportunity to start smokers on a quitting program. They lack, however, training, patient guides, and backup support. This research will provide a computerized evaluation/feedback system to triage patients in selecting cessation programs, as well as self-help uitting materials, training and intervention protocols, and backup support for patients and providers.National Heart, Lung, and Blood Institute (NLBI)
