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Community-based Training Models for Tobacco Cessation [NCI]

Myra Muramoto, MD, MPH

Cessation programs are a key component of comprehensive tobacco control, producing public health benefits more quickly, and with greater magnitude, than any other component. To maximize the reduction in smoking attained under a given tobacco control budget, the cost-effectiveness advantages of low-intensity treatments suggest that brief interventions should be extended to as many smokers as possible. The emphasis on healthcare providers and systems for broad dissemination has been insufficient, missing opportunities to activate the broad range of human service providers (e.g. social services, education, human resources, law and corrections, clergy, and community outreach workers) as interventionists. There is an urgent need to examine training models applicable to large-scale community-based implementation in terms of effectiveness, cost, accessibility and acceptability.  This project compares two models of brief intervention training to each other and to a usual practice control group within the target population of human services providers. The primary outcome is the rate of brief interventions for tobacco cessation performed in the community.  As a secondary measure, this project will test the effect of each model of training on rates of referral to more intensive tobacco cessation programs, and the attitudes and behaviors of training participants with regard to: reduction of environmental tobacco smoke (ETS) in personal spaces and support of tobacco control policies in the workplace and community.  This project is a partnership with Pima Community College.