Methods: Physicians and pharmacists from 16 Texas communities were randomized to receive training in either smoking cessation counseling (intervention) or in skin cancer prevention counseling (control). Approximately 3-hour-long tobacco cessation training focused on the 5A's and addressed both behavioral and pharmacologic methods for quitting. The impact of the training on providers' smoking cessation counseling practices was evaluated via patient exit interviews in medical offices and pharmacies at baseline (pre-training), and at 3 and 6 months post training (total n=3,900; 780 [20%] smokers).

Results: Patients of trained physicians reported an increase in Asking about smoking in the intervention group compared with the control group from baseline to 3 months (intervention: 39% to 58%; control: 34% to 30%, p<.01). There was also an increase in Advising smokers to quit from baseline to 3 month (intervention: 50% to 70%; control: 50% to 32%, p<.01). Finally, there was an increase in Assessing readiness to quit from baseline to 3 month (intervention: 35% to 56%; control: 33% to 26%, p<.05). At 6-month follow-up there were no significant increases in the 5A's outcomes except in Arranging follow-up (intervention: 0% to 25%; control: 10% to 14%, p<.05). Patients counseled by trained pharmacists reported significantly lower percentages of the 5A's compared to physicians both before and after training.

Conclusions: Physicians responded to training better than pharmacists; however, the effect was short-lived.