Original ArticleUse of the Vital Sign Stamp as a Systematic Screening Tool to Promote Smoking Cessation
Section snippets
PARTICIPANTS AND METHODS
Between February 1995 and December 1998, 9439 adults from Dane County, Wisconsin, participated in this study. Participants were approached as they exited 1 of 5 selected health care clinics in Madison. Any adults willing to participate were included. This resulted in a sample of 1611 participants who were current smokers, were older than 18 years, attended only 1 health care clinic, and gave informed consent to participate in the study. General demographic information is provided in Table 1.
RESULTS
To analyze the data regarding physician behavior, we conducted both descriptive and inferential analyses, with patient report serving as the basis for inference regarding physician behavior. For the descriptive analyses, we calculated the proportion of participants who reported that their physician had asked about smoking, advised them to quit, provided assistance in quitting, and arranged follow-up during the baseline and intervention phases. We also used these data to examine rates of quit
DISCUSSION
Although the vital sign stamp did increase the rates at which smokers were identified, it did not appear to promote further tobacco intervention efforts or subsequent successful quitting. Thus, the expanded vital signs changed behavior but only the specific behavior it targeted-asking about smoking. In this study, the vital sign stamp did not increase the rates at which physicians advised smokers to quit, offered assistance in quitting, or arranged follow-up. In fact, the descriptive data
CONCLUSION
The data point to an important although disturbing trend that a simple system-wide intervention is sufficient to change only the behavior it targets. The current intervention targeted asking about smoking, and it effectively increased rates at which participants were asked about their smoking. However, the vital sign stamp intervention was insufficient to instigate treatment of a chronic disease as complex as tobacco dependence. Given that the PHS guideline and other recent studies have shown
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This study was supported in part by grant HL52081-04 from the National Cancer Institute.