Offering smoking treatment to primary care patients in two Wisconsin healthcare systems: Who chooses smoking reduction versus cessation?

- Smoking reduction treatment may increase the proportion of smokers who enter tobacco treatment
- Individuals who selected reduction versus cessation were more likely to be older and have anxiety.
- Reducers have characteristics that increase the risk for relapse when a cessation attempt is made.
- Offering smoking reduction treatment may engage smokers otherwise unlikely to seek assistance.Clinical Trial Registration: ClinicalTrials.gov NCT01120704

Smokers unwilling to make a quit attempt can still benefit from smoking intervention. However, it is unclear what proportion of smokers will enter such a Motivation phase intervention, and whether such an intervention attracts different types of smokers than does abstinence oriented treatment. We conducted a study from June 2010 to October 2013 based on a chronic care model of tobacco treatment among study eligible primary care patients (N = 1579; 58% women, 89% White) presenting for regular health care visits in southern Wisconsin, U.S. Medical assistants, prompted via the electronic health record (EHR), invited smokers (n = 10,242) to learn more about treatment options to help them either reduce their smoking or quit. Of those invited to learn more who were then reached by study staff, 10.2% (n = 1046) reported interest in reduction treatment and 24% (n = 2465) reported interest in cessation treatment. Patients who selected and ultimately entered reduction (n = 492) versus cessation (n = 1087) were more likely to report: older age; a history of anxiety; lower motivation to quit; lower primary dependence motives; more close friends or family who smoke; and a greater interval since their last quit attempt. Results suggest that Motivation phase treatment aimed at smoking reduction may increase the proportion and range of smokers inducted into tobacco treatment.