This CRN 1 study examined tobacco policies and delivery of cessation services in nine non-profit HMOs that collectively provide comprehensive medical care to more than eight million members. Three annual surveys with health plan managers showed that all of these organizations had written tobacco control guidelines that became more comprehensive over the span of the study. The project also surveyed a random sample of 4,207 current smokers who had attended a primary care visit in the past year (399 to 528 at each of nine health plans). Of these smokers, 71 percent reported receiving advice to quit, 56 percent were asked about their willingness to quit, 49 percent were provided some assistance in quitting (mostly self-help material or information about classes or counseling), and 9 percent were offered some kind of follow-up. Smokers receiving assistance in quitting reported higher satisfaction with their care. In general, health plans with the most comprehensive policies also showed higher rates of implementing tobacco treatment programs in primary care.
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