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Journal of Public Health Advance Access published online on July 17, 2009
Journal of Public Health, doi:10.1093/pubmed/fdp072
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© The Author 2009, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

A cluster randomized trial in general practice with referral to a group-based or an internet-based smoking cessation programme


Charlotta Pisinger, Associate Professor1
Michael Milo Jørgensen, Research Assistant1
Niels Erik Møller, General Practitioner2
Martin Døssing, D.M.Sci3
Torben Jørgensen, Professor of Preventive Medicine1

1 Research Centre for Prevention and Health, Ndr. Ringvej, Glostrup University Hospital, DK-2600 Glostrup, Denmark
2 Holte Stationsvej 8-9, 2840, Holte, Denmark
3 Medicinsk Afdeling, Frederikssund sygehus, 3600 Frederikssund, Denmark


Address correspondence to Charlotta Pisinger, E-mail: chpi{at}glo.regionh.dk


  Abstract

Background Reviews state that there is a room for improvements of smoking cessation (SC) intervention in general practice.

Methods In 2005, all 61 general practitioners (GPs) in four municipalities in Copenhagen, Denmark, were invited to participate. Twenty-four GPs accepted and were cluster randomized to one of three groups: Group A, referral to group-based SC counselling (national model), n = 10; Group B, referral to internet-based SC programme (newly developed), n = 8; or Group C, no referral (‘do as usual’), n = 6. A total of 1518/1914 smokers were included, and 760 returned a questionnaire at 1-year follow-up.

Results The participating GPs reported significantly more SC counselling than GPs who refused participation (P = 0.04). Self-reported point abstinence was 6.7% (40/600), 5.9% (28/476) and 5.7% (25/442) in Groups A, B and C, respectively. Only 40 smokers attended group-based SC counselling, and 75 logged in at the internet-based SC programme. In cluster analyses, we found no significant additional effect of referral to group-based (OR: 1.05; 95% CI: 0.6–1.8) or internet-based SC programmes (OR: 0.91; 95% CI: 0.6–1.4).

Conclusions We found no additional effect on cessation rates of GPs' referring to group-based SC counselling or internet-based SC programme. This finding might, to some degree, be explained by the short time used by the GPs on SC counselling and the selection of the participating doctors.

Keywords: family practice, group-based, internet, referral and consultation, self-efficacy, smoking, smoking cessation


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