Smoking Push

A research, appearing in the current issue of the Archives of Internal Medicine, looked at plans that tie physician pay to the quality of care. The main measure was clinics’ referrals of patients in Minnesota to a tobacco quit line. Scientists compared clinics that were paid bonuses for making such referrals – $5,000 for 50 referrals and $25 for each referral beyond the initial 50 – to clinics that didn’t have a financial motive.

Paying providers of health care to refer patients for help in giving up smoking really makes a difference.

As it found out that the clinics that were in the pay-for-performance program made 1,483 referrals to the giving up line, an average of 11.4% of their patients who were smokers. Those that didn’t have the chance to earn extra money made 441 referrals, an average of 4.2% of their smokers. The scientists, led by Lawrence An of the University of Minnesota, noted some important factors for success beyond cold cash. For one, Minnesota health programs collaborated to make the referral process easy for the clinics. The clinics were also rewarded regardless of what health plan their patients belonged to, meaning that they could make the same recommendation to all smokers.

Blue Cross and Blue Shield of Minnesota, which funded the payments and study to the clinics with money from a tobacco settlement, decided along with a number of other Minnesota health plans to continue with the around smoking stop, although with lower financial awards.

Cigarette packs will carry new graphic warnings of smoking risks

Among the other images smokers will see: a corpse in a morgue, rotting lungs and a body cut open during surgery. Graphic pictures of rotting teeth and throat cancer are to appear on cigarette packs to illustrate the health risks of smoking.

The photos will appear on the back of packs with a written health warning.

The images replace the previous warnings introduced in January 2003, although the messages “Smoking seriously harms you and others around you” and “Smoking kills” will continue to appear on the front of packs. The Department of Health said new figures showed written warnings had motivated more than 90,000 smokers to call the NHS Smoking Helpline.

But, smoking is still the biggest killer in England where it is the reason of the premature death of more than 87,000 people each year. The photos are considered to be more effective than text, and research suggested that warnings should be changed from time to time to maintain their effectiveness.

The smokers’ lobby group Forest criticized the new warnings as “gratuitously offensive” and “unnecessarily intrusive”. Forest director Simon Clark said: “We support measures that educate people about the health risks of smoking, but these pictures are designed not just to educate but to shock and coerce people to give up a legal product. They are unnecessarily intrusive, gratuitously offensive, and yet another example of smokers being singled out for special attention.”