300,000 quitters and counting; A systematic approach to tobacco cessation

Objective

To describe Kaiser Permanente Northern California's (KPNC) systematic implementation of universal tobacco screening, evidence-based interventions, and performance measures to achieve long-term smoking cessation success.

Methods

We outline seven key components of KPNC's tobacco screening and intervention program that contributed to a significant decline in smoking prevalence. We also report changes in the prevalence of current smokers within KPNC from 2014 to 2023 using linear regression analyses.

Results

Key factors driving the success of the tobacco cessation program included risk-based screening algorithms, alert prompts for at-risk patients, system-wide medical champions, performance tracking, virtual coaching, widespread messaging, and comprehensive medication management. Implementing this multifaceted approach across all facilities was associated with a significant reduction in smoking prevalence, from 8.6% in 2014 to 5.8% in 2023 (p < 0.0001).

Conclusion

Our comprehensive, system-wide approach resulted in substantial public health gains and highlights the potential of similar preventive strategies as healthcare systems transition toward value-based care.