Trial reportAmerican journal of preventive medicine2013
The Ask-Advise-Connect approach for smokers in a safety net healthcare system: a group-randomized trial.
Trial report in American journal of preventive medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07073898 (Population Health Management Approaches to Increase Lung Cancer Screening in Community Health Centers - UG3 Pilot Clinical Trial), which is not on this map. Cited by 68 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Population Health Management Approaches to Increase Lung Cancer Screening in Community Health Centers - UG3 Pilot Clinical Trial
Who cites it
68 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- A Systematic Review of Electronic Community Resource Referral Systems.American journal of preventive medicine · 2023Pooled it
- Proactive Referral to Behavioral Smoking Cessation Programs by Healthcare Staff: A Systematic Review.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Pooled it
- Strategies to improve smoking cessation rates in primary care.The Cochrane database of systematic reviews · 2021Pooled it
- System change interventions for smoking cessation.The Cochrane database of systematic reviews · 2017Pooled it
- Use of electronic health records to support smoking cessation.The Cochrane database of systematic reviews · 2014Pooled it
- Engagement With Stop Smoking Services After Referral or Signposting: A Mixed-Methods Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.Translational behavioral medicine · 2022Trial
- A cluster randomized trial evaluating a teachable moment communication process for tobacco cessation support.BMC family practice · 2021Trial
- Implementation of Ask-Advise-Connect in a safety net healthcare system: quitline treatment engagement and smoking cessation outcomes.Translational behavioral medicine · 2020Trial
- Parent eReferral to Tobacco Quitline: A Pragmatic Randomized Trial in Pediatric Primary Care.American journal of preventive medicine · 2019Trial
- Evaluation of a population-level strategy to promote tobacco treatment use among insured smokers: a pragmatic, randomized trial.BMC public health · 2018Trial
- Trial
- The effects of framed messages for engaging adolescents with online smoking prevention interventions.Translational behavioral medicine · 2017Trial
- A randomized trial to evaluate primary care clinician training to use the Teachable Moment Communication Process for smoking cessation counseling.Preventive medicine · 2014Trial
- Implementing Sustainable Mobile Health Technology to Optimize a Smoking Cessation Program for Lao People With HIV (Project I-STOP): Protocol for a Hybrid Type-2 Pragmatic Effectiveness-Implementation Study.JMIR research protocols · 2026Article
- OUTPACE Tobacco study protocol: a tobacco-free workplace program for dissemination and implementation in opioid use treatment programs in Texas.Addiction science & clinical practice · 2026Article
- Development and evaluation of a quitline intervention commenced within an Australian smoke-free residential AOD withdrawal service.PEC innovation · 2026Article
- Creation of an mHealth Infrastructure to Support the Development and Delivery of mHealth Interventions: Protocol for Demonstration Projects Addressing Smoking Cessation in Cancer Care.JMIR research protocols · 2026Article
- An Electronic Health Record-Based Tobacco Treatment System for Parents in Pediatric Primary Care.Pediatrics · 2026Article
- Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
backgroundBecause smoking has a profound impact on socioeconomic disparities in illness and death, it is crucial that vulnerable populations of smokers be targeted with treatment. The U.S. Public Health Service recommends that all patients be asked about their smoking at every visit and that smokers be given brief advice to quit and referred to treatment. PURPOSE: Initiatives to facilitate these practices include the 5A's (ask, advise, assess, assist, arrange) and Ask-Advise-Refer (AAR). Unfortunately, primary care referrals are low, and most smokers referred fail to enroll. This study evaluated the efficacy of the Ask-Advise-Connect (AAC) approach to linking smokers with treatment in a large, safety net public healthcare system.
designThe study design was a pair-matched group-randomized trial with two treatment arms. SETTING/
participantsTen safety net clinics in Houston TX.
interventionClinics were randomized to AAC (n=5; intervention) or AAR (n=5; control). Licensed vocational nurses (LVNs) were trained to assess and record the smoking status of all patients at all visits in the electronic health record. Smokers were given brief advice to quit. In AAC, the names and phone numbers of smokers who agreed to be connected were sent electronically to the Texas quitline daily, and patients were proactively called by the quitline within 48 hours. In AAR, smokers were offered a quitline referral card and encouraged to call on their own. Data were collected between June 2010 and March 2012 and analyzed in 2012.
main outcome measuresThe primary outcome was impact, defined here as the proportion of identified smokers that enrolled in treatment.
resultsThe impact (proportion of identified smokers who enrolled in treatment) of AAC (14.7%) was significantly greater than the impact of AAR (0.5%), t(4)=14.61, p=0.0001, OR=32.10 (95% CI=16.60, 62.06).
conclusionsThe AAC approach to aiding smoking cessation has tremendous potential to reduce tobacco-related health disparities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.