Problem/Objective: Effective and efficacious treatments for tobacco dependence are essential to tobacco control and public health. This study evaluates the effectiveness of broad dissemination of an efficacious, group-based treatment for tobacco dependence and contributes to standards for program evaluation.

Methods: Public health, clinical, and research resources were utilized to design methods for program evaluation. Participant data was collected pre/post treatment and 3-and 12-months post-treatment. The treatment settings include 10 community health centers, 4 regional medical centers, 2 Area Health Education Centers, 1 county hospital, 1 economic development center, 1 private specialty clinic, and 1 obstetrics clinic. The participants were 3095 predominantly rural Arkansans. The intervention was evidence-based, six-session, multi-component cognitive-behavioral therapy with relapse prevention. The outcome measures include population penetrance, follow-up success, treatment completion rate, treatment satisfaction and perceived usefulness, 3-month and 1-year abstinence rates, and cost per patient treated.

Results: Penetrance - adequate; 3-month and 1-year response rates - 66.1% and 53.4%; treatment completion rate - 50.6%; treatment satisfaction and perceived usefulness scores were high; 3-month and 1-year abstinence rates - 19-40% and 13-32%; cost $489 per patient treated.

Conclusions: Broad dissemination of MCBT is an effective treatment for tobacco dependence, well-accepted by participants, cost-effective, and can utilize providers from a variety of backgrounds. Structured program evaluation, training for providers, treatment protocols, clinical supervision, and centralized systems for quality control and follow-up data collection are required.