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Nicotine & Tobacco Research Advance Access originally published online on April 7, 2009
Nicotine & Tobacco Research 2009 11(4):387-393; doi:10.1093/ntr/ntp017
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© The Author 2009. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Short-, intermediate-, and long-term outcomes of Pennsylvania's continuum of tobacco education pilot project

Frank T. Leone, Sarah Evers-Casey, Jon Veloski, Ashwin A. Patkar, Linda Kanzleiter and for the Pennsylvania Continuum of Tobacco Education work group

Frank T. Leone, M.D., M.S., Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA
Sarah Evers-Casey, M.P.H., Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA
Jon Veloski, M.S., Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA
Ashwin A. Patkar, M.D., Duke University School of Medicine, Duke University, Durham, NC
Linda Kanzleiter, Ph.D., The Pennsylvania Area Health Education Centers, Milton S. Hershey School of Medicine, Pennsylvania State University, Hershey, PA

Corresponding Author: Frank T. Leone, M.D., M.S., Center for Tobacco Research and Treatment, Thomas Jefferson University, 834 Walnut Street, Suite 650, Philadelphia, PA 19107, USA. Telephone: 215-955-7867; Fax: 215-955-0830; E-mail: frank.leone{at}jefferson.edu


  Abstract

Introduction: The most effective time to introduce formal tobacco use treatment training for physicians is during the medical school experience. However, few medical schools have adopted standardized curricula, missing an important opportunity to influence future physician behavior. The Pennsylvania Continuum of Tobacco Education pilot project was undertaken from spring 2003 through summer 2005 to evaluate a generalizable method of improving students’ knowledge, attitudes, and behaviors related to tobacco use treatment.

Methods: Intervention methods included a 1-day intensive multiformat seminar, followed by a reinforcement session 4 weeks later, within an internal medicine clerkship. Outcome measures included changes in students’ attitudes, rates of "ask" and "advise" behaviors during clinical encounters, and performance on end-of-year clinical skills examinations.

Results: Short, intermediate, and long-term outcomes related to both smoking assessment and counseling improved as a result of the intervention. The percentage of students who obtained tobacco histories and counseled patients in clerkships increased following the seminar compared with the baseline. Nearly, all students demonstrated relevant skills during a clinical skills assessment at the end of the third year.

Discussion: The introduction of a standardized tobacco curriculum into medical school training is both feasible and effective. Results were sustained following the intervention, and the effects were reflected across several valid outcomes.

Received: November 20, 2006; Accepted: September 6, 2007
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