REACHING MIDLIFE AND OLDER SMOKERS - TAILORED INTERVENTIONS FOR ROUTINE MEDICAL-CARE

Background. Although older adults can achieve significant health benef its from smoking cessation, few programs have specifically targeted th is population. This study tested the effectiveness of an office-based smoking cessation program tailored to midlife and older smokers. Metho ds. This paper describes a randomized controlled trial comparing usual care with physician-delivered brief quit-smoking advice and counselin g for midlife and older smokers (ages 50-74). Outpatient medical pract ices assigned to the Immediate Intervention (experimental) condition w ere trained to deliver brief quit-smoking advice and counseling. Delay ed Intervention (control) practices followed usual care procedures. Th irty-nine practices accruing five or more patients per practice were i ncluded in the analyses. Results. Using a conservative measure of quit ting, self-reported quit rates at 6-month follow-up were 15.41% for th e Immediate Intervention group versus 8.16% of subjects in the Delayed Intervention group (P < 0.005). Baseline subject (N = 659) characteri stics related to 6-month abstinence included number of previous quit a ttempts, quitting for 24 hr in the past year, desire to quit, confiden ce in quitting, perceived health benefits, and lower nicotine dependen ce.Conclusions. Smoking abstinence was significantly increased by trai ning physicians and key office and clinical staff to intervene with ol der smokers. Brief interventions tailored to this age cohort can be su ccessfully and efficaciously integrated into routine care. (C) 1996 Ac ademic Press, Inc.