Smoking Cessation

Improving Health Care Through Patient-Centered Outcomes Research (PCOR)

PCOR is research that compares the impact of two or more preventive, diagnostic, treatment, or health care delivery approaches on health outcomes. PCOR outcomes are those that are meaningful to patients and families, such as pain, symptoms, quality of life, and premature death. PCOR research can focus on specific clinical interventions (such as a medication or surgical procedure) or on ways of delivering care (such as the use of text messages to remind people to take a medication daily). PCOR evidence can come from individual studies, but often comes from comprehensive reviews of a large group of studies. Using PCOR evidence gives clinicians confidence that they are providing the best care to their patients.

Rationale for Smoking Cessation

About 42 million people in the United States (nearly 18 percent of the population) currently smoke.1 Tobacco use is a leading cause of illness, disability, and death in the United States. Cigarette smoking accounts for one out of every five deaths and is estimated to increase the risk for heart disease and stroke by two to four times.2 Smoking during pregnancy increases the risk of congenital anomalies, perinatal complications, miscarriage, and stillbirth. Substantial PCOR evidence shows that quitting smoking is one of the most important things a person can do for his or her health.

Findings From PCOR

In 2015, the U.S. Preventive Services Task Force released evidence-based recommendations for behavioral and pharmacological interventions to help people quit smoking. The recommendations are based on a systematic review of literature on the effectiveness of these interventions (Siu, 2015).

PCOR evidence strongly supports the use of behavioral interventions alone or in combination with pharmacotherapy. All pregnant women who smoke should receive behavioral interventions.

Evaluating and Measuring Use of PCOR-Supported Recommendations

The measure used by EvidenceNOW to evaluate smoking cessation support assesses the percentage of patients ages 18 and older who were screened for tobacco use and received a cessation counseling intervention if they were identified as a tobacco user. This measure has been endorsed by the National Quality Forum.
The EvidenceNOW goal is to have at least 70 percent of eligible patients in primary care practices receive smoking cessation counseling.

Additional Tools and Resources

Smokefree.gov provides evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking. The portal also contains information and resources for health professionals.
Tips from Former Smokers: This Web site features real people with compelling stories of their suffering as a result of smoking and exposure to secondhand smoke, along with resources to help smokers quit.

PCOR Evidence Sources

Siu AL, for the U.S. Preventive Services Task Force. Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: U.S. Preventive Services Task Force recommendation statement . Annals of Internal Medicine 2015;163(8):622-634.

1. Agaku IT, King BA, Husten CG, Bunnell R, Ambrose BK, Hu SS, et al, Centers for Disease Control and Prevention (CDC). Tobacco product use among adults—United States, 2012–2013. Morb Mortal Wkly Rep 2014; 63:542-7.

2. U.S. Department of Health and Human Services. The health consequences of smoking—50 years of progress: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.

Page last reviewed December 2016
Page originally created October 2016

Internet Citation: Smoking Cessation. Content last reviewed December 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/evidencenow/about/pcor-evidence/smoking-cessation.html