Clinical guidelines are only as good as the number of people who read and use them. In 2005, fewer than 50 percent of smokers visiting a health care setting were treated for tobacco use, according to the Center for Tobacco Research and Intervention at the University of Wisconsin. That gap occurred despite Treating Tobacco Use and Dependence, a clinical guideline from the U.S. Public Health Service published in 1996 and updated in 2000.
The center was the lead organization producing a 2008 update of the guideline, which recommends treatment options based on evidence about what works. For example, the update advises clinicians to prescribe both counseling and smoking-cessation medication to patients who want to quit unless otherwise contraindicated (as medication is with pregnant women). Eight organizations, including the Robert Wood Johnson Foundation (RWJF), funded the update (see Program Results).
To spur widespread use of the revised guideline, RWJF provided another grant to the center to update educational information and tools, create new tools and disseminate them to clinicians and consumers. This work, which ran from 2008 to 2009, built on a decade of efforts by RWJF to boost smoking treatment and quit rates. See the Special Report.
By 2008, many "people were eager to see the next guideline and use it," according to Bruce Christiansen, PhD, project co-director. However, they still needed information encouraging and helping them do so. The center used this grant to provide that support.
Key Results: In reports to RWJF, project staff noted the following results as of December 31, 2009:
Afterward: The Center for Tobacco Research and Intervention continues to provide ad hoc assistance to a variety of organizations both nationally and internationally. For example, in June 2010, the center assisted the American Heart Association in its development of Coronary Heart Disease Secondary Prevention Guidelines regarding recommendations for the treatment of tobacco dependence.
In addition, the center has moved from disseminating information on the guideline to helping to implement it, according to Christiansen.