Annals
Established in 1927 by the American College of Physicians

FOR THE PRESS

25 September 2012 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians on the first and third Tuesday of every month. These highlights are not intended to substitute for articles as sources of information. For a copy of an article, call 215-351-2653 or e-mail Angela Collom at acollom@acponline.org

1. Evidence Review: Behavioral Counseling Interventions Can Reduce Problem Drinking

Alcohol misuse is the third leading cause of preventable death in the United States after tobacco use and being overweight. About 30 percent of the U.S. population admits to alcohol misuse, with most engaging in what is considered risky drinking, or drinking more than is recommended during a given time period. Researchers reviewed 23 randomized, controlled trials that lasted at least six months in duration to evaluate the effect of behavioral counseling interventions on reducing alcohol misuse. All enrolled persons had their alcohol misuse identified by screening in a primary care setting and were then randomly assigned to receive counseling intervention or usual care. The spectrum of alcohol misuse included risky or hazardous drinking to alcohol dependence. The researchers found that behavioral counseling interventions improved drinking behavior outcomes and reduced hospital stays for adults with risky drinking. The most effective interventions were brief (10 to 15 minutes per contact) multicontact interventions delivered by primary care physicians with some additional support from a nurse or health educator. Over the long-term, participants in intervention groups maintained reductions in alcohol consumption over control subjects for about four years, when differences in behaviors were no longer statistically significant. For most health outcomes, such as mortality, there was no difference between intervention and control groups.

2. Short-term Response Suggests that Emotive ‘Tips’ Campaign May Influence Smokers to Quit

In March 2012, the Centers for Disease Control and Prevention (CDC) launched the nation’s first federally funded mass media campaign to encourage smokers to quit. The “Tips from Former Smokers” campaign featured real smokers sharing in graphic terms what it is like to live with disfiguring or disabling tobacco-related diseases. Based on short-term response, the CDC deems the campaign a success. According to the CDC’s Office on Smoking and Health, calls to the toll-free quit line more than doubled during the 12-week campaign and hits to the website tripled. According to the authors of an Annals opinion piece, physicians should recommend the campaign to their patients who smoke. Recent reviews find strong evidence that mass media campaigns increase quitting and reduce smoking prevalence when implemented within the context of a comprehensive tobacco control program. In addition, emotionally laden personal testimonials have proven to be powerful strategies for reaching and influencing smokers, as smokers are less likely to discount adverse health outcomes related to smoking when they are hearing about them from real people. The authors urge the CDC to coordinate future efforts with the U.S. Food and Drug Administration which is planning graphic tobacco warning labels paired with information on how to get help quitting.