Abstract

Introduction: Healthcare providers should facilitate smoking cessation, and primary care is an ideal setting for delivering this evidence-based care. This study’s objective was to describe readiness to quit smoking combustible cigarettes among adult Appalachian primary care patients and determine their providers’ implementation of an established tobacco treatment model.

Methods: As part of a randomized clinical trial, 298 providers in 10 health systems across 4 states received tobacco treatment training. Periodically between January 2022 and June 2023, anonymous surveys were distributed to patients after primary care visits. The survey included questions about demographics, visit type, smoking status, readiness to quit, and provider behavior related to tobacco treatment implementation. In 2023, descriptive statistics, bivariate tests and logistic regression models were conducted.

Results: Among 1,242 survey respondents, 34.1% reported current smoking. Among those who reported current smoking, 13.9% expressed readiness to quit within the next 30 days and 15.3% reported readiness in 1−6 months while 36.7% indicated “never” wanting to quit. Nearly all providers asked respondents about smoking status (96.9%) and advised them to quit (89.8%); fewer providers engaged in cessation assistance by discussing behavioral counseling, discussing medication options, and/or prescribing medication (25.1%−64.6% across behaviors). Provider behavior was most consistently associated with patient age and visit type.

Conclusions: Nearly one third of Appalachian patients who smoke reported readiness to quit within 6 months and nearly all received advice to quit from their provider. Patients would benefit from more intensive tobacco treatment delivery in primary care settings, with a focus on assisting with quit attempts.

Document Type

Article

Publication Date

2025

Notes/Citation Information

© 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Digital Object Identifier (DOI)

https://doi.org/10.1016/j.amepre.2024.09.017

Funding Information

This study was funded by a grant from the National Institutes of Health (P01 CA229143) and supported by The Ohio State University Comprehensive Cancer Center Recruitment, Intervention and Survey Shared Resource (P30 CA016058); The Ohio State University Center for Clinical and Translational Science (UL1 TR001070); the Markey Cancer Center Patient-Oriented and Population Sciences Shared Resource Facility (P30 CA177558); and K07 CA181351 (JLB). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funder had no role in the study design; collection, analysis, and interpretation of the data; writing of the manuscript; or decision to submit this manuscript for publication. The institutional review board protocol number for this study is #2020C0040.

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