Rural pilot smoking cessation program proves beneficial

Rural pilot smoking cessation program proves beneficial
Rural pilot smoking cessation program proves beneficial

At the Carle Clinic in Mattoon, Ill., 22 percent of patients self-identify as smokers, on par with the national average in rural areas.* Many smokers report wanting to quit but feel they cannot do so without assistance. Only 15 percent of smokers who saw a health care provider in the past year were offered assistance and only 3 percent were given a follow-up appointment to address quitting.**

Prior to the implementation of Beat the Pack, a pilot smoking cessation program introduced last year at Carle Clinic, rural Coles County had no formal smoking cessation program. Smoking is an important risk factor for heart disease and lung cancer — both health priorities where the clinic is located. Beat the Pack helps take the burden off busy providers who don’t always have time for smoking cessation counseling at patient appointments.

Group education benefits 

Beat the Pack was modeled after the American Lung Association’s Freedom From Smoking program, and consists of a four-week program in contrast to ALA’s eight weeks. Its format is a weekly group education/counseling session with instructor-led discussion including topics on reasons to quit, coping with the urge to smoke, longterm benefits of quitting, and staying off tobacco. Participants also had the option of using medications to assist in smoking cessation.

The format was chosen because of the value of group support for smoking cessation. Members of the group act as co-therapists through the feedback they provide. Groups also provide positive peer support and peer pressure to abstain from smoking and make smokers feel less isolated, as participants can watch the progress of others recovering. Members of groups find it easier to maintain motivation and get through difficult periods than those trying to quit alone.***

The pilot was successful in that all of the participants either quit or reduced the number of cigarettes smoked by the end of the program and maintained this progress six months later. Follow-up phone calls served as accountability for the participants, and good feedback was obtained from the participants to further improve the program.


Recruitment and retention for rural group education/counseling programs for smoking cessation can be problematic. To overcome them:

  • Use a variety of outreach and recruitment strategies.
  • Encourage participants to invite family members to attend the sessions.
  • Consider targeting certain groups of patients for recruitment, such as those who will be undergoing surgery.
  • Explore making the program available online.

Kristi Esker is a family nurse practitioner at Carle Clinic in Mattoon, Ill.

* Source: Centers for Disease Control and Prevention. (2014). National Survey on Drug Use and Health. Retrieved from

** Source: Centers for Disease Control and Prevention. (2005). Management of nicotine addiction: fact sheet. Retrieved from

*** Source: Ramos, M., Ripoll, J., Estrades, T., Socias, I., Fe, A., Duro, R., Gonzalez, M., & Servera, M. (2010). Effectiveness of intensive group and individual interventions for smoking cessation in primary health care settings: A randomized trial. BMC Public Health, 10, 89-95.