Effectiveness of minimal intervention by general practitioners with their smoking patients: a randomised, controlled trial in France

Correspondence to : Karen Slama, Service de Pneumologie, H?pital Saint Louis, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France Abstract Objective To investigate the impact of a very minimal smoking cessation inter vention in general practice in 1991. Design A randomised, controlled clini cal trial. Setting -The practices of 372 general practitioners in the region Provence Alpes-C?te d'Azur in France. Subjects Smoking patients seen in office consultations over a four-week period. Intervention Doctors asked their patients if they smoked, and gave brochures to those smokers who wanted to stop. Controls were not questioned about their smoking. Main outcome measures Self-reported initial smoking cessation and sustained abstinence for one year following the trial. Results A total of 5560 smokers received the intervention. A random sample of 2199 smokers who gave their consent to be re-contacted was compared with 929 smokers identified among a random sample of controls who consented to be re-contacted. Cessation at one month was significantly higher among smokers re ceiving the intervention (6.8% 4.1%; difference = 2.7 percentage points, 95 % confidence interval (CI) = 1.05 to 4.35; 2 = 8.379, df = 1, < 0.005). For those who stopped at one month, differences in abstinence remained at 12-month follow up: 1.9% in the experimental group had remained abstinent without relapsing since the one-month follow up, compared with 0.5 % among controls (difference = 1.4 percentage points, 95% CI = 0.67 to 2.13; 2 = 8.304, df = 1, < 0.005). Conclusion General practitioners may have increased cessation among their smoking patients in the month following their consultation by up to 60% over natural cessation rates by simply asking about smoking and providing material for smokers who wished to stop. Smokers receiving the intervention were more likely to remain abstinent; at 12 months, the rates for sustained abstinence were four times greater than those among controls.