Comparing Smoking Cessation Interventions for Work-Site Disease Management
Smoking cessation continues to be one of the most cost-effective preventive measures for work-site disease management. The US Public Health Service Clinical Practice Guideline, entitled `Treating Tobacco Use and Dependence,' provides guidance for evaluating and choosing smoking cessation programs for work sites. Smoking cessation interventions can be characterized by the resource intensity of the effort, the format and methods of interacting with patients and the focus and objectives of the content. These features are compared with typical group, phone and Internet-based program options. Pharmacotherapy treatment recommendations are reviewed as well as characteristics of first-line nicotine replacement therapy (NRT) medications (e.g. nicotine patch, gum, spray and inhaler) and bupropion. It is suggested that work-site recruitment and participation campaigns may fail for a variety of reasons including: 1. too narrowly cast recruitment messages; 2. inadequate exposure to campaign messages; 3. lack of immediate and accessible enrollment mechanisms; and 4. passive rather than active outreach. Four broad issues to consider when comparing outcomes data from potential smoking cessation programs are: 1. at what follow-up point(s) is the quit rate measured?; 2. is there a comparison group?; 3. how was quit status determined?; and 4. how is the status of participants who are lost to follow-up calculated in the outcomes data?
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