Simplicity matters: Using system-level changes to encourage clinician intervention in helping tobacco users quit

摘要

The articles in this supplement explore the fundamental problem of how to design systems-level changes that make it easier for clinicians to help more tobacco users quit. Smoking remains a huge problem among Americans, with 46 million still smoking and 440,000 dying each year from smok-ing-related illness (Schroeder, 2004). Another 8.6 million are debilitated by tobacco-caused diseases (Centers for Disease Control and Prevention, 2000). Seventy percent of smokers want to quit, but few succeed, and advice from a health professional can double their chances of quitting (Fiore et al., 2000). Even so, most clinicians do not intervene with smoking patients, though this single step could lengthen and improve many patients' lives. When asked why they do not intervene, clinicians offer at least eight reasons: (1) They are too busy; (2) they lack expertise in smoking cessation; (3) they have no financial incentive to do so; (4) they know most smokers won't succeed in quitting; (5) they think smoking is thesmokers' own fau (6) they respect smokers' privacy and don't want to interfere; (7) they are afraid of scaring away patients with a negative message; and (8) they themselves smoke, (http:// smokingcessationleadership.ucsf.edu).