Problem/Objective: Tobacco dependence is a chronic condition that requires repeated intervention. Effective treatments exist and every patient who uses tobacco should be offered at least one of these treatments in accordance with recommendations of the Public Health Service guideline. Each year over a million and a half of NY smokers visit a health care provider. NYS has implemented a program that seeks to insure that clinicians systematically screen and counsel all patients for cessation.

Methods: In 2004 NYS funded 19 cessation centers. Their primary deliverable was to implement policies within healthcare settings to screen for tobacco use and provide brief cessation interventions at every patient visit. The implementation of these policies is challenging due to provider confidence, time constraints and competing priorities. The cessation centers have used multiple strategies; top level buy-in, academic detailing, site specific training and assessment, mini grants, quitline and fax-to-quit referrals and smoke free hospital campaigns. These strategies in concert across the state provide a sustained pressure on the health care community to treat tobacco dependency.

Results: There are indicators of success. Our adult tobacco survey administered quarterly asks identified smokers if they have been Asked Advised, or Assisted by their health care provider to quit smoking. The percentage of smokers who reported receiving “Assistance” with quitting from their health care provider increased substantially from Q3 2003 (38%) to Q1 2006 (58%).

Conclusions: A statewide program of cessation centers is a promising intervention to impact the health care community's adoption of the PHS guidelines.