The American Stop Smoking Intervention Study (ASSIST), the most comprehensive tobacco control intervention trial to be conducted in the United States, was a $165 million project of the National Cancer Institute and the American Cancer Society (White & Bero, 2004). This and other projects have been launched do to the fact that cigarette smoking is the single most preventable cause of death and disability in the United States (Himelhoch & Daumit, 2003). Interventions are numerous and include policies, media, and program services that are delivered through worksites, schools, health care settings, and community groups (White & Bero, 2004).
Smoking is related to diseases such as chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD). Smoking cessation is the only intervention that is effective in slowing the progression of COPD and smoking cessation has been shown to be related to reductions in risk of all causes of mortality in CHD patients (Critchley & Capewell, 2003; Sherman, Lanto, Nield, & Yano, 2003). Thus smoking cessation interventions are important for all individuals but their efficacy is of particular concern for primary care patients.
The problem is that while multiple interventions are in place to help educate and assist individuals with smoking cessation, the primary care patient suffering from COPD, CHD and other life-threatening illnesses, continues to smoke. Sherman, et al. (2003) presented findings from a study of COPD patients who were advised to quit smoking, prescribed nicotine patches, or referred to a smoking cessation program. Findings showed that rates of smoking cessation were the same for this group, as compared to smokers without COPD. Thus intervention efforts failed to result in adequate smoking cessation. An intervention was needed that addresses social contextual factors involved in smoking behaviors, in order to assist this and other disease patients. This research s...