Helping Addicted Smokers Quit

The Foundation's Tobacco-Cessation Programs

The Robert Wood Johnson Foundation often supports research or demonstration projects to determine whether a specific type of intervention works—a new organizational strategy, an innovative financing method, an improved treatment. The thought behind this approach is that good ideas are picked up and spread widely. This does not always happen, however. Perhaps the research is convincing, but something more is needed before it gets translated into standard practice. Such is the case with tobacco cessation. The research clearly shows the benefits of certain approaches—those employing counseling and pharmaceuticals. These approaches don't even take much time. Yet they are not widely practiced by physicians or within health care organizations. This chapter examines the Foundation's efforts to translate research into practice to help smokers quit.

The long translation effort began with research to determine which interventions were effective. Once effective treatments were identified and formalized in federal guidelines issued in 1996, the Foundation sought to make them a regular part of medical practice. Its approach included publicizing the guidelines, using them as the basis of standards, attempting to create demand for them, and coaxing insurers to cover the cost of using them.

Much of the Foundation's work has been with managed care organizations. As organized delivery systems that can track patients and benefit from keeping people healthier, managed care organizations should have an incentive to offer a preventive service such as tobacco cessation.