Innovative Initiative to Help Patients Quit Smoking

Embracing its public health mandate, the Office of Continuing Professional Development in Medicine and Public Health (CME) at the University of Wisconsin School of Medicine and Public Health (SMPH) has begun a national continuing medical education (CME) initiative to improve public health by reducing the number of Americans who smoke.

Called Cease Smoking Today, or CS2day, the initiative will educate at least 46,000 physicians and other healthcare professionals on effective ways to help patients quit smoking.

George Mejicano, MD, MS, associate dean for continuing professional development and the overall leader of CS2day, is collaborating with key national organizations to leverage their strengths for what is seen widely as a public health imperative.

"We expect to increase knowledge of treatment options, improve counseling skills and provide tools for primary care clinicians, cardiologists, pulmonologists, psychiatrists, pharmacists and other healthcare professionals," says Mejicano.

The CS2day initiative is first-of-a-kind for a variety of reasons:

• Nine organizations are involved
• Four distinct CME models will be used to improve performance and patient outcomes by helping physicians redesign their practices and systems of care
• The American Board of Internal Medicine is considering adopting the Performance Improvement Module created by the SMPH for its own use
• Some clinicians will be given licenses to use handheld devices to improve their skills in counseling and prescribing strategies to help smokers quit
• Patient- and population-level outcomes will be measured
• Pfizer Inc. has provided an unprecedented $12 million unrestricted educational grant spanning three years
• Two research studies designed by SMPH staff (a study of clinics that have made significant improvements in their smoking cessation practices and a test of an innovative approach to evaluating the clinical impact of complex initiatives like CS2day) will be embedded in the initiative
• The program will reach clinicians repeatedly as they learn new competencies to help people quit

The curriculum is built around the recent revision of the U.S. Public Health Service tobacco use and dependence clinical practice guidelines released in May 2008. SMPH faculty and staff from the UW-Madison Center for Tobacco Research and Intervention were deeply involved in developing the guidelines.

Educational formats that include a variety of traditional and non-traditional CME activities will be used. The activities will provide effective and clinically relevant strategies for intervening and increasing smoking quit rates for patients in practice settings across the country.

Mejicano says the initiative should help determine whether collaboration among national CME providers is feasible and productive.

The other partners include the California Academy of Family Physicians, CME Enterprise, Healthcare Performance Consulting, Interstate Postgraduate Medical Association, Iowa Foundation for Medical Care (the quality improvement organization for Iowa and Illinois), Physician's Institute for Excellence in Medicine (a nonprofit foundation of the Medical Association of Georgia), Purdue University School of Pharmacy and Pharmaceutical Sciences, and the University of Virginia School of Medicine.

by Dian Land
This article appears in the winter 2009 issue of Quarterly.