June 2000

Grant Results

SUMMARY

From 1996 to 1997, the University of Wisconsin-Madison Medical School, Center for Tobacco Research and Intervention developed strategies for dissemination of the Agency for Health Care Policy and Research's (AHCPR) Clinical Practice Guideline on Smoking Cessation to a broad spectrum of health care providers.

Subsequently, from 1997 to 2000, five organizations of health professionals carried out dissemination activities tailored to their constituencies. The organizations included:

Drafted by an expert panel, the guideline provides primary care clinicians, smoking cessation specialists, health care administrators, insurers and purchasers with recommendations on interventions that have been demonstrated to be effective in scientific studies.

The Agency for Health Care Policy and Research is the federal agency that supports research designed to improve the quality of health care, reduce its costs and broaden access to essential services.

Key Results

  • The project helped raise awareness among approximately 150,000 health care providers regarding the availability and utility of the guideline as a clinical tool at a time when tobacco control issues were commanding national attention.

Funding
The Robert Wood Johnson Foundation (RWJF) supported this project through six grants — one to each of the organizations above — totaling $235,654.

 See Grant Detail & Contact Information
 Back to the Table of Contents


THE PROBLEM

Tobacco use constitutes the most serious common medical problem in the United States. Yet, access to effective treatment remains limited for most Americans. More than 70 percent of smokers see a physician each year, but only about a third of them receive any medical advice or assistance on how to quit smoking.

Most physicians and nurses want to help their patients quit, but cite long-standing practice barriers. One barrier to wider treatment has been the lack of accepted clinical practice guidelines.

In April 1996 the US Agency for Health Care Policy and Research (AHCPR) — which supports research designed to improve the quality of health care, reduce its costs, and broaden access to essential services — released its Clinical Practice Guideline on Smoking Cessation. Drafted by an expert panel, the guideline provides primary care clinicians, smoking cessation specialists, and health care administrators, insurers, and purchasers with recommendations on interventions that have been demonstrated to be effective in scientific studies.

The guideline is a potentially important new tool for widening treatment access for tobacco users who want to quit and for incorporating tobacco prevention and cessation interventions into routine primary care. Drafters of the guideline believe the intervention strategies, if universally adopted by providers, could result in more than 2 million new ex-smokers per year.

Research indicates that providers are motivated to implement treatment guidelines when such guidelines are endorsed by providers' professional societies and when the guidelines include practical tools for their use. A number of clinician groups had expressed interest in reviewing, endorsing, and implementing the AHCPR guideline.

In May 1996 RWJF gave a grant to the American Medical Association (see Grant Results on ID# 029466) to create and disseminate to its members a more concise, pocket version of the guideline, which bore the AMA and AHCPR logos. RWJF also funded the Dana-Farber Cancer Institute (see Grant Results on ID# 029471) to disseminate the guideline to organized labor.

Prior to the release of the AHCPR guideline, an RWJF grant (see Grant Results on ID# 028757) supported a series of meetings among health policy and industry leaders to develop for health plans certain measures that would track the success of smoking cessation interventions. Those measures were subsequently included among other indicators of health care quality in the Health Employer Data Information Set (HEDIS), the most widely used performance measurement system for managed care.

RWJF also supported the evaluation of an effort by Allina Medical Clinic, a large multispecialty group practice in Minneapolis, Md., to implement the guideline (see Grant Results on ID#s 030499 and 036023). In addition, RWJF developed a new national program, Tobacco in Managed Care, for evaluation of techniques to promote smoking cessation interventions among HMOs and other managed care groups.

 Back to the Table of Contents


THE PROJECT

These grants from RWJF supported the dissemination of the AHCPR Clinical Practice Guideline on Smoking Cessation. The overall goal was to provide a broad spectrum of health care providers with recommendations on effective interventions for patients who use tobacco, including patients in high-risk groups, such as pregnant smokers, older adults with chronic disease, children, and adolescents.

The first grant (ID# 029389) supported investigators at the University of Wisconsin-Madison Medical School, Center for Tobacco Research and Intervention, to develop strategies for the dissemination program and to provide oversight of the project.

Five other grants were awarded to individual physician and nursing groups so that each organization could tailor the guideline to its respective constituency. These groups were selected because their members regularly intervene with tobacco users. The groups included the:

  • American Academy of Pediatrics (ID# 030329), which has an active national committee on substance abuse
  • American College of Chest Physicians (ID# 030525) — specialists in cardiopulmonary disease — administered through Creighton University
  • American Medical Women's Association (ID# 030375), which has targeted tobacco as a serious women's health issue
  • American College of Obstetricians and Gynecologists (ID# 030520), which also worked in concert with the American Medical Women's Association
  • American Nurses Foundation (ID# 030254), which has access to nurse-clinician members of the American Nurses Association

 Back to the Table of Contents


RESULTS

University of Wisconsin-Madison Medical School, Center for Tobacco Research and Intervention (ID# 029389)

  • Worked with a broad range of health care organizations to promote adoption and use of the guideline and to develop strategies for its dissemination. The organizations included major managed care and provider organizations in Hawaii; the American Society of Anesthesiology and the International Anesthesia Research Society; Allina Health System of Minnesota, a nonprofit health organization that is the parent organization of the Allina Medical Clinic; the American Occupational Therapy Association; the American Psychological Association; the National Medical Association (NMA), which is the equivalent of the AMA for minority physicians; the American College of Chest Physicians; the American Nursing Foundation; and the American Medical Women's Association. The NMA also received a grant from RWJF to support its dissemination projects (see Grant Results on ID# 030028).
  • Worked with the state of Michigan to promote integration of smoking cessation services into the state's health care systems. As part of this effort, project staff planned and implemented a statewide conference, "Saving Lives, Saving Dollars: Integrating Smoking Cessation into Michigan Health Care Systems." The conference — cosponsored by the Michigan Department of Community Health, the Michigan Health and Hospital Association, the Michigan State University Managed Care Institute, the Michigan Primary Care Organization, and the Association of Michigan HMOs — drew medical directors, chief financial officers, clinical directors, and health system administrators from throughout the state.

American Academy of Pediatrics (AAP) (ID# 030329)

  • Sent a mailing to its 53,000 members in August 1997. This included AHCPR's "Quick Reference Guide for Smoking Cessation Specialists," AHCPR's consumer guide "You Can Quit Smoking," a reprint from AHCPR's "Children and Adolescents: Primary Prevention of Tobacco Addiction," and AAP brochures "The Risks of Tobacco Use: A Message to Parents and Teens" and "Smoking: Straight Talk for Teens."
  • Promoted availability of the foregoing resources in the February 1997 issue of AAP News.
  • Sponsored a Smoking Cessation Training Workshop at its 1997 annual meeting.

The American College of Obstetricians and Gynecologists (ACOG) (ID# 030520)

  • Sent a physician education mailer on smoking cessation to ACOG's 38,000 members in September 1997. It included two publications: AHCPR's "Helping Smokers Quit: A Guide for Primary Care Physicians," reprinted with the ACOG logo, and a patient education pamphlet, "It's Time to Quit Smoking." The mailing included a message from ACOG's president, who used smoking cessation as her presidential initiative during 1997. (ACOG applied funds budgeted for its presidential initiative to supplement RWJF funds in completing the dissemination.) The mailing also included a physician continuing medical education bulletin on smoking and women's health. ACOG featured other articles on the guideline in its monthly newsletter, ACOG Today, mailed under separate cover to its membership.
  • Sent a physician education mailer on smoking cessation to ACOG's members in February 1998. The mailer included tools to help obstetrician-gynecologists implement AHCPR-recommended smoking cessation interventions. The tools included chart stickers to remind clinicians to ask about tobacco use and offer treatment, a quick reference card with information on counseling and nicotine replacement products, and a catalog of resources for helping pregnant women quit smoking.
  • Conducted a master-faculty training workshop for ACOG members in partnership with the American Medical Women's Association (AMWA). The workshop, "How Physicians Can Influence Female Patient Smoking Behavior through Clinical Practice and Community Involvement," was held October 8, 1997, at the ACOG office in Washington, D.C. Six ACOG members participated in the daylong program, in which they received instruction in the latest smoking cessation treatments and instruction on how to conduct additional training sessions with additional groups of obstetrician-gynecologists.
  • After the workshop, mailed participants a description of a one-hour smoking cessation presentation as a model for future presentations. Then ACOG developed a slide library with speaker notes for trainers to use in their presentations. To date, three ACOG trainers have conducted 13 workshops in New York and Arizona, reaching approximately 380 health care professionals.
  • Added a clinical seminar and plenary session on smoking cessation to the 1998 annual clinical meeting.

American Medical Women's Association (AMWA) (ID# 030375)

  • Collaborated with ACOG on the design and implementation of a master-faculty training program for AMWA members. The program highlights information from the guideline with an emphasis on issues relevant to women (see previous ACOG description). Ten AMWA physicians from across the United States were trained. Each participant subsequently conducted at least one training session on smoking cessation; several conducted two or more. After the training, the AMWA distributed slide kits with talking points to assist trainees in making presentations on smoking cessation. (See the Bibliography for details.) Due to staffing shortages, the AMWA did not conduct a survey to determine the impact on clinical practice of the guideline dissemination and the master-faculty training.
  • Reprinted and distributed the AMA/AHCPR pocket version of the guideline. A cover letter from AMWA's president encouraged the 13,000 AMWA member physicians to use the guideline in daily practice and pointed out specific problems that women and girls may experience when attempting to quit smoking. AMWA's bimonthly newsletter, What's Happening in AMWA, carried articles on how to obtain the guideline.
  • Distributed the AMA/AHCPR pocket version of the guideline to approximately 300 attendees at its First International Advanced Curriculum on Women's Health.
  • Received an extension of the grant period to allow for time to produce a special supplemental section on women and tobacco in an issue of the Journal of the American Medical Women's Association slated for publication in summer 2000. The issue will also contain articles on smoking among women and adolescent girls. (See After the Grant.)

American Nurses Foundation (ANF) (ID# 030254)

  • Produced a slide program, "How Nurses Can Effectively Implement the AHCPR Smoking Cessation Clinical Practice Guideline No. 18," and distributed it to the 53 state nurses associations that are constituent members of the American Nurses Association (ANA), which has a total membership of 50,000 nurse clinicians. The program consists of 50 slides and an accompanying narrative that can be used at the states' conventions.
  • Mailed to 29,394 nurse practitioners a brochure, "Helping Smokers Quit: A Guideline for Advanced Practice Nurses."
  • Developed two articles on smoking cessation interventions for publication. These were published in the peer-reviewed journals Nursing Clinics of North America and Perspectives in Respiratory Nursing.
  • Developed an ANA position statement, Environmental Tobacco Smoke.
  • Provided information that was placed on the Nursing Center for Tobacco Intervention Web site. The ANF did not evaluate the effectiveness of the Web site or the written materials, which was an original objective of the grant.
  • Developed and disseminated 50 additional slide sets and brochures to nurse members of the Vascular Nurses Association and the Respiratory Nurses Association.

American College of Chest Physicians (ACCP) (ID# 030525)

  • Reprinted and distributed the full AHCPR guideline in registration packets during the 63rd International Scientific Assembly, Chest 1997, held in New Orleans, La., in November 1997.
  • Mailed the full AHCPR guideline along with the journal Chest to 11,800 ACCP members in February 1998.
  • Sponsored Michael Fiore, M.D., M.P.H., from the University of Wisconsin Medical School in a "Meet the Professor" symposium during its annual meeting on October 29, 1997.
  • An article planned for the ACCP's journal, Chest, was submitted after the grant period (See After the Grant.) The ACCP postponed development of a policy statement until after publication of the article in Chest.

Communications

Each of the five funded professional organizations developed individual dissemination plans tailored to its constituency, described earlier in Results of the Projects. Several of the organizations have continued dissemination beyond the grant period. (See After the Grant.) Communication activities were described previously and are listed in the Bibliography.

 Back to the Table of Contents


LESSONS LEARNED

  1. Good timing can increase the effectiveness of a dissemination effort. Several of the organizations said that the increased national attention to tobacco issues during 1997 and 1998 helped facilitate their activities in dissemination of the guideline.
  2. Organizations often can use existing programs to maximize the impact of a grant-supported initiative. ACOG's president chose smoking cessation as her presidential initiative. This both provided additional funding from ACOG and increased visibility for the dissemination project. The AAP chose tobacco use among youth as the topic for its Child Health Month, October 1997. The activities of that month helped raise the visibility and the impact of the dissemination project.
  3. Organizations that become identified as experts on a topic may face a challenge in responding to increased requests for information and assistance. During the dissemination period, the American Nurses Association became identified as a key source of information for nurses on smoking cessation, but was unable to respond to all information requests.
  4. Recruiting busy clinicians to become trainers in master-faculty programs is a challenge. Some of ACOG and AMWA's physicians had difficulty scheduling time both for their initial master-faculty training and for workshops to train others.
  5. Train-the-trainer approaches may require more logistical support. The physicians trained to present workshops had difficulty with the administrative tasks of setting up workshops. Neither the ACOG nor the AMWA had the staff needed to provide that support.
  6. Train-the-trainer methodology may be outmoded. Increasingly, managed care organizations make decisions about the standards of care to be adopted. The training of individual providers, while important, may be inefficient for influencing long-term systems changes, according to RWJF's program officer.

 Back to the Table of Contents


AFTER THE GRANT

  • The AMWA plans to devote a portion of its summer 2000 issue of Journal of the American Medical Women's Association to the topic of women and smoking.
  • The ACOG plans to use the smoking cessation effort as a springboard for focusing on the problem of smoking and pregnancy through a renewal grant from RWJF (see Grant Results on ID# 038611), which will fund the dissemination to obstetricians of a best-practice intervention for smoking cessation during pregnancy to make smoking cessation a routine part of prenatal care. The ACOG is developing another slide presentation on the topic and is creating a number of education publications and materials for distribution to its members.
  • The ANF presented the guideline at the National Student Nurses Association annual meeting in April 1998, the Vascular Nurses Association annual meeting in June 1998, and the Respiratory Nurses Association annual meeting in March 1999. A version of its smoking cessation continuing education program was scheduled for publication in September 1999 in seven regional editions of Nursing Spectrum, with an expected circulation to 500,000 nurses. The ANF plans to apply for another RWJF grant to support creation of a smoking cessation peer-education program for youth.
  • An article, "Effective Treatment for Tobacco Dependence: The AHCPR Smoking Cessation Clinical Practice Guideline," was submitted in July 1999 to Chest, the journal of the American College of Chest Physicians. Development of the ACCP policy statement on smoking cessation will proceed after the article's publication.
  • The AHCPR expects to issue a revised smoking cessation guideline by mid-2000. RWJF is the major funder of that revision effort (ID# 034068, to the University of Wisconsin-Madison Medical School) and is considering — when the new guideline is complete — a dissemination strategy similar to the one employed in this project. A number of the groups participating in this project may reapply for dissemination funds.

 Back to the Table of Contents


GRANT DETAILS & CONTACT INFORMATION

Project

Dissemination of the AHCPR Clinical Practice Guideline on Smoking Cessation

Grantee

University of Wisconsin-Madison Medical School (Madison,  WI)

  • Amount: $ 43,894
    Dates: June 1996 to December 1997
    ID#:  029389

Contact

Michael C. Fiore, M.D., M.P.H.
(608) 262-8673

Grantee

American Academy of Pediatrics, Inc. (Elk Grove Village,  IL)

  • Amount: $ 50,000
    Dates: February 1997 to January 1998
    ID#:  030329

Contact

Jill Mallin
(847) 981-7941

Grantee

The American College of Obstetricians and Gynecologists (Washington,  DC)

  • Amount: $ 15,545
    Dates: February 1997 to January 2000
    ID#:  030520

Contact

Janet Chapin, R.N., M.P.H.
(202) 863-2579

Grantee

American Medical Women's Association Inc. (Alexandria,  VA)

  • Amount: $ 49,902
    Dates: February 1997 to December 2000
    ID#:  030375

Contact

Michele Bloch, M.D., Ph.D.
(703) 838-0500

Grantee

American Nurses Foundation Inc. (Washington,  DC)

  • Amount: $ 49,905
    Dates: February 1997 to September 1998
    ID#:  030254

Contact

Virginia Burggraf, M.S.N., R.N.
(202) 651-7068
Vburrgra@ana.org

Grantee

Creighton University (Omaha,  NE)

  • Amount: $ 26,408
    Dates: February 1997 to January 1998
    ID#:  030525

Contact

Walter J. Scott, M.D.
(402) 280-4139
wscott@creighton.edu

 Back to the Table of Contents


BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Articles

University of Wisconsin-Madison Medical School (ID# 029389)
Fiore MC. "AHCPR Smoking Cessation Guideline: A Fundamental Review." Tobacco Control, 6(Suppl. 1): S4–S8, 1997.

Fiore MC. "Overview of the Agency for Health Care Policy and Research Guideline." Tobacco Control, 7(Suppl.): S14–S16, 1998.

Fiore MC, Jorenby DE and Baker TB. "Smoking Cessation Principles Practice Based upon the AHCPR Guideline, 1996." Annals of Behavioral Medicine, 19(3): 213–219, 1997. Abstract available online.

Wetter DW, Fiore MC, Gritz ER, Lando HA, Stitzer ML, Hasselblad V and Baker TB. "The Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline: Findings and Implications for Psychologists." American Psychology, 53(6): 657–669, 1998. Abstract available online.

Presentations and Testimony

University of Wisconsin-Madison Medical School (ID# 029389)
Michael Fiore, "AHCPR Guideline Summary," at the Alliance Quality Forum, Madison, Wis., June 4, 1996.

Michael Fiore, "AHCPR Guideline Summary," at the Conference for Nurse Practitioners in Women's Health, Milwaukee, Wis., June 5, 1996.

Michael Fiore, "AHCPR Guideline Summary," at the ASCO/NCI Symposium on Tobacco Addiction, Bethesda, Md., June 21, 1996.

Michael Fiore, "Treating Tobacco Dependence: Guideline," at the Comprehensive Cancer Center Grand Rounds, Madison, Wis., July 3, 1996.

Michael Fiore, "Clinical System Guideline Recommendations," at the meeting with state managed care organizations in Hawaii, August 1996.

Michael Fiore, "Guideline Goals and Impact," at the AHCPR Conference, Washington, D.C., September 17, 1996.

Michael Fiore, "Treating Tobacco Dependence: Guideline for the Future," at the Continuing Medical Education Teleconference, Madison, Wis., October 1, 1996.

Michael Fiore, "Saving Lives, Saving Dollars," at Integrating Smoking Cessation into Michigan Health Care Systems, East Lansing, Mich., November 8, 1996.

Michael Fiore, "AHCPR Guideline Summary," at Medical Grand Rounds, Northwestern University, Chicago, Ill., November 15, 1996.

Michael Fiore, "How to Help Your Patients Stop Smoking," for local physicians and health care administrators, Atlantic City, N.J., January 27, 1997.

Michael Fiore, "AHCPR Guideline Summary," at the Family Practice Refresher Course, Salt Lake City, Utah, March 24, 1997.

Michael Fiore, "AHCPR Guideline Summary," at the Preventive Cardiology Symposium, Madison, Wis., April 4, 1997.

Michael Fiore, "New Approaches in Smoking Cessation," a videoconference, North Carolina, May 7, 1997.

Michael Fiore, "Smoking Cessation/Guideline Summary," at the American Psychiatric Association, San Diego, Calif., May 18, 1997.

Michael Fiore, "AHCPR Guideline Summary," at the Milwaukee Medical Clinics, Milwaukee, Wis., July 13, 1997.

Michael Fiore, "AHCPR Guideline Summary," at Columbia Los Robles Hospital, Thousand Oaks, Calif., August 6, 1997.

Michael Fiore, "Smoking Cessation Alternatives," at the Chicago Thoracic Society Scientific Lecture Series, Chicago, Ill., October 1997.

Michael Fiore, "AHCPR Guideline Summary," at the American College of Chest Physicians Clinical Congress, San Francisco, Calif., October 29, 1997. Approximately 300 in attendance.

Michael Fiore, "The Emerging Role of Public Health," at the American Medical Association/American Public Association Media Briefing, New York, N.Y., December 2, 1997.

Michael Fiore, "New Therapies in Smoking Cessation," at the CME Presentation, St. Vincent's Hospital, Green Bay, Wis., December 11, 1997.

Michael Fiore, "A Clinical and Systems Perspective on Tobacco Control: The AHCPR Guideline," at Addressing Tobacco in Managed Care: Partnering for Success, Arlington, Va., February 4, 1998.

Michael Fiore, "What Works: Cessation Tools," at the Partnership for Prevention Capitol Hill Forum Series on National Tobacco Policy, Washington, D.C., February 26, 1998.

Michael Fiore, "The Purchaser's Role in Smoking Cessation: How to Improve Health and Save Money," for Wisconsin State Medicaid Program staff, Madison, Wis., March 11, 1998.

Michael Fiore, "Smoking and Pregnancy," at the Neonatologist Grand Rounds, Meriter Hospital, Madison, Wis., April 7, 1998.

Michael Fiore, "Impact of Smoking in the Workplace," at Wellness Coordinators for Wisconsin Corporations, Brookfield, Wis., April 22, 1998.

Michael Fiore, "Treating Tobacco Addiction: Guideline for the New Millennium," at the 46th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists, New Orleans, La., May 9–13, 1998.

Brochures and Fact Sheets

American Medical Women's Association (ID# 030375)
"Helping Smokers Quit," Agency for Health Care Policy and Research, 1998. 13,000 copies produced; 11,500 copies distributed to date.

Sponsored Conferences

American Medical Women's Association (ID# 030375)
"How Physicians Can Influence Female Patient Smoking Behavior through Clinical Practice and Community Involvement," October 8, 1997, Washington D.C. Attended by 27 individuals from organizations including the American Medical Women's Association, the American College of Obstetricians and Gynecologists, and the Centers for Disease Control and Prevention. Eight presentations were made:

  • Michele Bloch, M.D., Ph.D., "Smoking as a Women's Issue."
  • Sally Faith Dorfman, M.D., M.S.H.S.A., "The Agency for Health Care Policy and Research Clinical Practice Guidelines on Smoking Cessation" and "Smoking Cessation in Clinical Practice for Girls and Women."
  • Harry Lando, Ph.D., "Smoking Cessation."
  • Lorraine Greaves, Ph.D., "Psychology of Women's Smoking."
  • Mildred Morse, J.D., "Special Issues for African-American Women."
  • Jeannette Noltenius, Ph.D., "Special Issues for Latina Women."
  • Phil Wilbur, "Advocacy on Tobacco."

Presentations and Testimony

American Medical Women's Association (ID# 030375)
Paula Scariatti, "Smoking Cessation Forum for Physicians," at the American Osteopathic Association Annual Meeting, San Antonio, Texas, October 21, 1997.

Annette Kussmaul, "Booth to Distribute AHCPR Guidelines," at the Annual Meeting of the American College of Chest Physicians, New Orleans, La., October 27–29, 1997.

Sally Faith Dorfman, "Agency for Health Care Policy and Research Guideline for Smoking Cessation," at the 82nd Annual Meeting of the American Medical Women's Association, Chicago, Ill., November 7, 1997. Attended by 700 women physicians and medical students.

Margaret Stager, "Women and Smoking," at the Elective: Health Issues for Young Women, Case Western Reserve University, Cleveland, Ohio, February 6, 1998.

Michele Bloch and Roslyn Epps, "Smoking Prevention and Cessation," at the Advanced Curriculum on Women's Health — First International Conference, Miami, Fla., March 20, 1998. Attended by 300 international physicians.

Carolyn Dresler, "Therapy for Lung Cancer," at the Pulmonary Physicians' Workshop, June 19, 1998.

Paula Scariatti, "Smoking Cessation," at the Public Forum at the Better Breathers Club, Oneida, N.Y., September 10, 1998.

Margaret Stager, "Smoking Cessation Workshop, Pediatric and Adolescent Gynecology," at postgraduate course at Harvard Medical School and Children's Hospital, Boston, Mass., September 10, 1998.

Sandy Hoffman, "Smoking Cessation," at the Internal Medicine roundtable for students and residents at Michigan State University, Kalamazoo Center for Medical Studies, September 16, 1998.

Carolyn Dresler, "Nicotine Addiction and Smoking Cessation," at the Lecture Question and Answer in Denver, Colo., September 21, 1998.

Sandy Hoffman, "Smoking Cessation," at the Internal Medicine roundtable for students and residents at Michigan State University, Kalamazoo Center for Medical Studies, September 25, 1998.

Kathryn Schneider, "Smoking Cessation," for nurses and office staff at Middlesex Hospital, Middletown, Conn., October 1998.

Kathryn Schneider, "Smoking Cessation," for physicians at Middlesex Hospital, Middletown, Conn., October 1998.

Susan Stewart, "Smoking Cessation in Clinical Settings (1 hr)," at Bassett Hospital of Scholarie County, Cobleskill, N.Y., October 21, 1998.

Susan Stewart, "Smoking Cessation in Clinical Settings (3 hr)," at Bassett Hospital of Scholarie County, Cobleskill, N.Y., October 21, 1998.

Hogai Nassery, "Smoking Cessation," at the Smoking Cessation Workshop, Atlanta, Ga., October 23, 1998.

Hogai Nassery, "Smoking Cessation," at the informal lunch workshop at Atlanta, Ga., October 27, 1998.

Sandy Hoffman, "Tobacco Use by Women and Girls and Strategies for Smoking Cessation," at the women's health symposium at Michigan State University, Kalamazoo Center for Medical Studies, October 30, 1998.

Carolyn Dresler, "Smoking Cessation: Physicians' Workshop," at the American College of Chest Physicians, November 3, 1998.

Margaret Stager, "Update on Teens and Smoking," at the pediatric grand rounds presentation at Metro Health Medical Center, Cleveland, Ohio, December 12, 1998.

Audio-Visuals and Computer Software

American Medical Women's Association (ID# 030375)
Smoking Cessation — Model Talk and Slide Kit. Alexandria, Va.: American Medical Women's Association, 1998.

Print Coverage

American Medical Women's Association (ID# 030375)
"Tobacco Control Achievements." What's Happening in AMWA, 17(1): 3, February 1997. 10,000 copies disseminated to date.

"Smoking Cessation Training Available." What's Happening in AMWA, 17(3): 3, April–May, 1997. 10,000 copies disseminated to date.

"AMWA Continues to Lead in Tobacco Control for Women." What's Happening in AMWA, 17(7): 5, December 1997. 10,000 copies disseminated to date.

"Smoking Cessation Project in Final Stages." What's Happening in AMWA, 19(1): 1, October–November 1998. 10,000 copies disseminated to date.

"Smoking Cessation: RWJ Grant." What's Happening in AMWA, 19(2): 9, December 1998–January 1999. 10,000 copies disseminated to date.

Presentations and Testimony

American Academy of Pediatrics (ID# 030329)
Roslyn Epps, M.D., and Mark Manley, M.D., "Training Session: Smoking Cessation Techniques for the Pediatric Office Setting," at the annual meeting of the American Association of Pediatrics, New Orleans, La., November 3, 1997.

Press Kits and News Releases

American Academy of Pediatrics (ID# 030329)
A smoking cessation information packet was mailed to 53,000 AAP members in August 1997.

Print Coverage

American Academy of Pediatrics (ID# 030329)
"Dr. Epps Tips Off Academy to Smoking Cessation Grant," in AAP News. Elk Grove Village, Ill.: American Academy of Pediatrics, February 1997. 57,000 mailed.

Brochures and Fact Sheets

American College of Obstetricians and Gynecologists (ID# 030520)
"A Message from Your President — Smoking Cessation and Your Patients: How You Can Make a Difference…with Chart Stickers." American College of Obstetricians and Gynecologists. 38,000 copies distributed in February 1998.

"A Message from Your President — Smoking Cessation and Your Patients: How You Can Make a Difference…with Nicotine Replacement Therapy and Referrals…and by Using the 4 A's." American College of Obstetricians and Gynecologists, Baltimore, Md., Cavanaugh Press, February 1998. 38,000 copies distributed.

"Healthy Moms Healthy Babies Healthy Families…Helping Your Patients Quit Smoking." University of Alabama at Birmingham Department of Medicine/Division of Preventive Medicine, Smoke-Free Families Technical Assistance and Dissemination Project, Madison, Wis., Wisconsin Clearinghouse for Prevention Resources, 1997. 38,000 copies distributed in February 1998.

"Helping Smokers Quit — a Guide for Primary Care Clinicians." Agency for Health Care Policy and Research, Washington, D.C., U.S. Government Printing Office. 38,000 copies distributed in September 1997.

"It's Time to Quit Smoking." American College of Obstetricians and Gynecologists, Washington, D.C., July 1996. 38,000 copies distributed in September 1997.

"Smoking Cessation and Your Patients: How You Can Make a Difference." American College of Obstetricians and Gynecologists, Baltimore, Md., Cavanaugh Press, 1997. 38,000 copies distributed in September 1997.

Sponsored Conferences

American College of Obstetricians and Gynecologists (ID# 030520)
"How Physicians Can Influence Female Patient Smoking Behavior through Clinical Practice and Community Involvement," October 8, 1997, Washington D.C. Attended by 27 individuals from organizations including the American Medical Women's Association, the American College of Obstetricians and Gynecologists, and the Centers for Disease Control and Prevention. Eight presentations were made:

  • Michele Bloch, M.D., Ph.D., "Smoking as a Women's Issue."
  • Sally Faith Dorfman, M.D., M.S.H.S.A. "The Agency for Health Care Policy and Research Clinical Practice Guidelines on Smoking Cessation" and "Smoking Cessation in Clinical Practice for Girls and Women."
  • Harry Lando, Ph.D., "Smoking Cessation."
  • Lorraine Greaves, Ph.D., "Psychology of Women's Smoking."
  • Harry Lando, Ph.D., "Smoking Cessation."
  • Mildred Morse, J.D., "Special Issues for African-American Women."
  • Jeannette Noltenius, Ph.D., "Special Issues for Latina Women."
  • Phil Wilbur, "Advocacy on Tobacco."

"Smoking Cessation: A Vital Part of Ob-Gyn Practice," Workshop:

  • Presented by Myron Gordon, November 21, 1997, Buffalo, N.Y. 15 attendees.
  • Presented by Murray Nusbaum, November 21, 1997, Syracuse, N.Y. 27 attendees.
  • Presented by Myron Gordon, December 3, 1997, Ellis Hospital, Schenectady, N.Y. 13 attendees.
  • Presented by Myron Gordon, January 15, 1998, St. Peter's Hospital, Albany, N.Y. 35 attendees.
  • Presented by Murray Nusbaum, January 28, 1998. Children's Hospital/SUNY-HSC, Buffalo, N.Y. 50 attendees.
  • Presented by Murray Nusbaum, February 13, 1998, Champlain Valley Physicians Hospital Medical Center, Plattsburgh, N.Y. 28 attendees.
  • Presented by Murray Nusbaum, February 24, 1998, Albert Einstein Medical College, New York, N.Y. 37 attendees.
  • Presented by Murray Nusbaum, February 26, 1998, E.J. Noble Hospital in Gouvemeur, N.Y. FACOG. 13 attendees.
  • Presented by Murray Nusbaum, March 26, 1998, University School of Medicine, St. Louis, Mo. 15 attendees.
  • Presented by Murray Nusbaum, April 7, 1998, St. Peter's Hospital, Albany, N.Y. 35 attendees.
  • Presented by Murray Nusbaum, Myron Gordon, and Michele Bloch, May 11, 1998, ACOG Annual Clinical Meeting, New Orleans, La. 35 attendees.
  • Presented by Robert Holland, July 9, 1998, Marcus J. Lawrence Medical Center, Cottonwood, Ariz. 17 attendees.
  • Presented by Robert Holland, January 22, 1999, Northland Perinatal Consultants, Flagstaff, Ariz. 25 attendees.
  • Presented by Murray Nusbaum, Myron Gordon, and Richard Windsor, May 19, 1999, ACOG Annual Clinical Meeting, Philadelphia, Pa. 40 attendees.

Presentations and Testimony

American College of Obstetricians and Gynecologists (ID# 030520)
Michael Fiore, "Guideline on Smoking Cessation," at the ACOG Annual Clinical Meeting, New Orleans, La., May 9, 1998. Approximately 1,500 attendees.

Virginia Lupo, "Preventing Smoking Relapse," at the January 1999 Executive Board Meeting, Washington, D.C., January 12, 1999.

Press Kits and News Releases

American College of Obstetricians and Gynecologists (ID# 030520)
"Be Good to Yourself. Smoking Hurts You" poster. American College of Obstetricians and Gynecologists, Washington, D.C., January 1999. 2,000 copies printed.

News Conferences

American College of Obstetricians and Gynecologists (ID# 030520)
"A Media Update on Adolescent Health, Protecting Our Daughters Health," New York, N.Y., December 9, 1997. Attended by multiple media representatives. Presentation made by Vickie L. Seltzer, M.D.: "Women's Health: Up in Smoke."

Print Coverage

American College of Obstetricians and Gynecologists (ID# 030520)
"Smoking Cessation Guideline Offers Help to Kick the Habit." ACOG Newsletter, January 1997. Circulation of 38,000.

"Smoking Cessation and Your Patients: How You Can Make a Difference." ACOG Today, September 1997. Circulation of 38,000.

"The Time Is Now. Make These Years Your Best Today." Advertisement placed in Managing Menopause, Fall/Winter 1997.

"Great American Smokeout: November 20." ACOG Today, October 1997. Circulation of 38,000.

"Kudos to Jane Brody…Pressures That Can Lead Young Girls to Smoke," letter to the editor, by Vickie L. Seltzer, M.D., in The New York Times, carried in Arizona Republic, November 1997. Circulation of 365,979.

"When Quitting Spells Success," Women's Health column by Vicki L. Seltzer, M.D.. Carried in Florida Sentinel Bulletin (circulation 23,485); Daily News (8,000); Burlington County Times (41,000); Norman Transcript (15,632); Antigo Daily Journal (7,000); New Age Examiner (5,500); Northern Wyoming Daily (4,249); Alliance Review (12,000); Times (7,650). November 1997.

"Fellows Can Broadcast Health Messages through Hometown Radio Program." ACOG Today, November/December 1997. Circulation of 38,000.

"November 20 is the Great American Smokeout." ACOG Today, November/December 1997. Circulation of 38,000.

"Ob-Gyns Launch Campaign to Help Women Quit Smoking." Women's Health Weekly, November 24, 1997.

"ACOG Continues Smoking Cessation Campaign." ACOG Today. January 1998. Circulation of 38,000.

"An Unkind World for Girls," by Patricia Anstett. Detroit Free Press, January 1998. Syndicated throughout the United States, reaching a minimum of 1.3 million.

"Applications Sought for ACOG Issue of the Year Award." ACOG Today, January 1998. Circulation of 38,000.

"How to Keep this Resolution from Going up in Smoke," by Sandra Brown Kelly. Roanoke Times, January 1998. Circulation 113,054.

"Letter to Ann Landers on Girls and Smoking," by Vickie L. Seltzer, M.D.. January 1998. Ann Landers's column is syndicated to 1,500 newspapers and has a readership of 90 million.

"Workshops 'Train the Trainers' on Smoking Cessation Techniques." ACOG Today, January 1998. Circulation of 38,000.

"Clinical Seminar on Smoking Added to Annual Clinical Meeting Options." ACOG Today, March 1998. Circulation of 38,000.

"So small. So harmful. Now that you're pregnant…Help your baby. Help yourself. Quit smoking today." Advertisement placed in Healthy Pregnancy, Fall/Winter 1998.

"Great American Smokeout: November 20." ACOG Today, October 1998. Circulation of 38,000.

Radio Coverage

American College of Obstetricians and Gynecologists (ID# 030520)
"Hometown Smoke-Out Radio Interviews." Released November 1997. Audience impressions of 74 million.

Articles

American Nurses Foundation (ID# 030254)
Wewers ME, Ahijevyeh KL and Sarna L. "Smoking Cessation Interventions in Nursing Practice." Nursing Clinics of North America, 33(1): 61–74, 1998.

Wewers ME and Burkley A. "Smoking Cessation: New Therapies." Perspectives in Respiratory Nursing, 9(1): 5, 10, 1998.

Brochures and Fact Sheets

American Nurses Foundation (ID# 030254)
"Helping Smokers Quit: A Guide for Advanced Practice Nurses." American Nurses Foundation. 1997. 30,000 copies produced, 29,394 of which were mailed to pediatric, school, adult, family, geriatric, and acute nurse practitioners.

Presentations and Testimony

American Nurses Foundation (ID# 030254)
"Implementation of the AHCPR Guideline," at the National Student Nurses Association Annual Meeting, April 1998. About 80 in attendance.

Virginia Burggraf, M.S.N., R.N., "Implementation of the AHCPR Guideline," keynote address at the Vascular Nurses Association Annual Meeting, Washington, D.C., June 1998. 500 in attendance.

Lynn Reinke, M.S.N., R.N., and Kathy Lindell, M.S.N., R.N., "Smoking Cessation: Implications for Nursing," at the Respiratory Nurses Association, 9th Annual Meeting, Chicago, Ill., March 4, 1999. 500 in attendance.

Audio-Visuals and Computer Software

American Nurses Foundation (ID# 030254)
How Nurses Can Effectively Implement the AHCPR Smoking Cessation Clinical Practice Guideline No. 18, a set of 50 slides and an accompanying narrative. Washington, D.C.: American Nurses Foundation, 1997. 80 copies produced, 53 of which were sent to each of the 53 constituent members of the American Nurses Association.

Print Coverage

American Nurses Foundation (ID# 030254)
"How Nurses Can Effectively Implement the AHCPR Smoking Cessation Clinical Practice Guideline No. 18: Written Curriculum." In seven regional issues of Nursing Spectrum, September 7, 1999. Combined circulation of 500,000 nurses. Also available online.

Articles

Creighton University (ID# 030525) (American College of Chest Physicians)
Woller SC, Jorenby DE, et al. "Effective Treatment for Tobacco Dependence: The AHCPR Smoking Cessation Clinical Practice Guideline." Forthcoming.

Presentations and Testimony

Creighton University (ID# 030525) (American College of Chest Physicians)
Michael Fiore, "Meet the Professor Symposium: The Implication of the AHCPR Smoking Cessation Guideline," at the annual meeting of the American College of Chest Physicians, New Orleans, La., October 29, 1997.

Press Kits and News Releases

Creighton University (ID# 030525) (American College of Chest Physicians)
The AHCPR guideline was mailed to the 15,000 members of the American College of Chest Physicians in February 1998.

 Back to the Table of Contents


Report prepared by: Kelsey Menehan
Reviewed by: Richard Camer
Reviewed by: Janet Heroux
Program Officer: Tracy Orleans

Most Requested