Short-, intermediate-, and long-term outcomes of Pennsylvania's continuum of tobacco education pilot project

Introduction: The most effective time to introduce formal tobacco use treatment training for physicians is during the medical school experience. However, few medical schools have adopted standardized curricula, missing an important opportunity to influence future physician behavior. The Pennsylvania Continuum of Tobacco Education pilot project was undertaken from spring 2003 through summer 2005 to evaluate a generalizable method of improving students' knowledge, attitudes, and behaviors related to tobacco use treatment. Methods: Intervention methods included a 1-day intensive multiformat seminar, followed by a reinforcement session 4 weeks later, within an internal medicine clerkship. Outcome measures included changes in students' attitudes, rates of 'ask' and 'advise' behaviors during clinical encounters, and performance on end-of-year clinical skills examinations. Results: Short, intermediate, and long-term outcomes related to both smoking assessment and counseling improved as a result of the intervention. The percentage of students who obtained tobacco histories and counseled patients in clerkships increased following the seminar compared with the baseline. Nearly, all students demonstrated relevant skills during a clinical skills assessment at the end of the third year. Discussion: The introduction of a standardized tobacco curriculum into medical school training is both feasible and effective. Results were sustained following the intervention, and the effects were reflected across several valid outcomes.