Background. Only recently have clinical programs for smoking cessation
become available in some medical centers. Counselor intervention serv
ices are provided to Mayo patients, most of whom are physician referre
d. Each patient receives a 45- to 60-min consultation and then is enro
lled in a structured follow-up/relapse prevention program. Methods. In
1989, 224 of 1764 patients referred by their physicians for consultat
ion did not receive the consultation. This cohort was surveyed 1 year
after referral to determine smoking status. We compared these patients
to a cohort of 578 patients who were seen in 1988 for counseling and
received the follow-up program. Results. Of those referred, 87.3% rece
ived consultation. There was a 10.7%, 1-year point prevalence self-rep
orted smoking cessation rate for those who were referred but did not f
ollow through compared with 23.0% for those seen by the counselor and
who received the follow-up program. Conclusions. In a medical setting,
physician referral for nicotine dependence intervention and counselor
-provided services is associated with a high attendance rate. Receivin
g counselor-provided consultation and follow-up was associated with a
doubling of the stop rate. Such counselor services have substantial ut
ility. There is a need for broader implementation of this type of serv
ice in medical centers. (C) 1995 Academic Press, Inc.