Effect of direct physician involvement on tobacco abstinence rates and other variables affecting participants of a freedom from tobacco class.

CONTEXT: Kaiser Permanente measures how often tobacco users are offered strategies to quit but not the success of such strategies.
OBJECTIVE: To compare tobacco abstinence rates for participants of the Kaiser Permanente Riverside (California) Medical Center's Freedom from Tobacco Class in 2008, before direct physician involvement, and in 2009, after direct physician involvement, and to compare other variables affecting these rates.
DESIGN: In a retrospective study, participants were divided into two groups based on year of participation. Data were collected using electronic medical records and phone interviews. MAIN OUTCOME MEASURES: Tobacco use status between both groups at 1, 3, 6, and 12 months after the classes started and within groups by sex, number of classes attended, medication received, and class teacher.
RESULTS: The 12-month abstinence rates were 27% in 2008 and 33% in 2009 (p = 0.3). The abstinence rate for men improved from 23% to 38% (2008 vs 2009; p = 0.05), whereas for women it was 30% vs 27% (p = 0.7). Abstinence rates decreased over time for the group as a whole (p < 0.001). Attendance of 6 or more classes was associated with higher abstinence rates. There was no significant impact on abstinence rates due to age, body mass index, class teacher, or medications used.
CONCLUSION: Direct physician involvement improved men's but not women's abstinence rates among class participants. The relapse rate was significant over the first year after the class. Further research is needed to study the difference between sexes and the factors affecting relapse.