Jess Cook Presents Research at Grand Rounds on Motivating Patients to Quit Smoking

Jess Cook HeadshotUW-CTRI Researcher Dr. Jessica Cook (left) presented on innovative approaches to treating smokers who are unwilling to quit during the UW Department of Medicine Grand Rounds March 22 at the William S. Middleton Memorial Veterans Hospital in Madison.

Cook told clinicians that, while Wisconsin leads the nation in advising patients to quit smoking, there is still plenty of work to be done on the leading preventable cause of disease and death. For example, at any given primary care visit, 70 percent of smokers are unwilling to quit, and most of these smokers leave their clinical encounter without treatment.

She shared results from the UW-PASS Study, which is guided by the Phase-Based Model of Cessation. This approach, developed by Dr. Tim Baker, suggests the process of cessation can be divided into phases, each with different opportunities for intervention. Dr. Cook presented results from the Motivation Phase, which involves identifying intervention components for smokers who are aren’t ready to quit.

The Phase-Based Model of tobacco cessation was developed by UW-CTRI Research Director Dr. Tim Baker. 
The Phase-Based Model of tobacco cessation was developed by UW-CTRI Research Director Dr. Tim Baker.

Cook said the research team found that smokers who are not ready to quit will engage in treatment and stay in treatment. In fact, nearly half requested more treatment.

In this fully crossed randomized design, interventions included nicotine patch, gum, reduction counseling and motivational interviewing strategies for six weeks starting with an in-person clinic visit.

Of 1,699 participants enrolled in the overall study, 517 (30 percent) were not interested in quitting but were willing to reduce their smoking. Among the primary care patients not seeking smoking treatment who participated in the UW Pass Study, 30 percent chose the Motivation Phase.

Cook said the research team found that, while the nicotine gum and counseling to reduce smoking improved odds of quitting, the nicotine patch did not. It also seemed likely that readily available cessation treatment is important when treating smokers who are unwilling to quit, she said.

“Offering reduction treatment may induce smokers to enter cessation treatment who might not otherwise,” she said. “If you’re willing to take three minutes to intervene, it will increase the likelihood they will quit.”

Donna Hoekstra quit smoking

UW-PASS Participant Donna Hoekstra (right) initially didn’t want to quit smoking. “I didn’t want somebody to tell me, ‘you have to quit,’” Hoekstra said. “I would just dig in my heels. Enough is enough, it’s my life. The fact that you supplied me with the patch, that was a good thing. (The health counselor) would call me every week, and that would help.” Hoekstra didn’t want to fail or let anyone down. She overcame withdrawal and quit smoking. “Somebody told me to think of it as a bell, it rings but it stops ringing. That has been a good one.”