Please select the eligibility criteria that correspond to the clinical trial below.
Title: Quitlink : A Leveraging Solution to Tobacco Counseling
Brief Summary: Primary: To test whether the delivery of A3-5 smoking cessation counseling (Assess, Assist, Arrange) in primary care offices is enhanced by a system that couples (1) an expanded vital sign intervention with (2) fax referral of preparation-stage patients for telephone counseling and (3) feedback to the provider. The question will be examined in a randomized trial, with practices as the unit of analysis and with a control intervention consisting of a conventional vital sign intervention. The experiment will therefore compare what intervention and control practices accomplish beyond simply identifying patients who use tobacco.

Secondary: To assess contextual factors that might affect implementation of the intervention and account for its ultimate success or failure. In particular, to assess: (1) environmental and practice-level factors that affect practices' ability to successfully implement and use the intervention and; (2) patient characteristics beyond readiness to change (i.e., age, gender, race/ethnicity) that affect willingness to use the quit line and complete counseling.


Options:
A: Inclusion Criteria:

* Current use of tobacco
* Age 18 or older
* Visit with a clinician that day
* Patient at one of the 16 practices in the study

Exclusion Criteria:

* Unable to participate in a self-administered exit survey
B: Inclusion Criteria:

* willing to remain abstinent post discharge
* 1 cpd past 30 days
* active phone
* has a usual source of care
* willing to participate
* willing to provide contact information for follow up
* provide informed consent

Exclusion Criteria:

* critical care or labor/delivery units
* pregnant or breastfeeding
* physically unable to participate
* cognitively impaired
* no phone
C: Inclusion Criteria:

* Receive a minimum of four mental health treatment sessions from the SOPP that span at least a 1-month interval
* SOPP treatment plan must indicate intent to deliver ongoing PTSD care for at least 1 year, including visits at least once per month
* Diagnosis of PTSD resulting from military trauma using DSM-IV criteria
* Current nicotine use, smoking greater at least 10 cigarettes per day for at least 16 of the past 30 days prior to randomization
* Demonstrated motivation to quit smoking

Exclusion Criteria:

* Use of smokeless tobacco or smoke pipes or cigars
* Any psychotic disorder that is not in remission
* Bipolar disorder that is not in remission
* Any substance dependence disorder that is not in remission (current substance abuse disorder and substance dependence disorder in remission for more than 1 month are not exclusions)
* Imminent risk for suicide or violence, as determined during routine assessment by SOPP clinical staff
* Severe psychiatric symptoms or psychosocial instability likely to prevent participation in the study protocol (i.e., attendance at scheduled sessions, ability to read study materials, and/or ability to comprehend interventions), as determined during routine assessment by SOPP clinical staff
* Gross impairment from organic mental disorder, as determined during routine assessment by SOPP clinical staff
D: Inclusion Criteria:

* Clinics are included if they are located within the NYC metropolitan area and employ at least three FTE dentists.
* Providers are included if they practice full-time or part-time at one of the study clinics
* Patients are included if they are 18 years or older, active smokers defined as those who report smoking cigarettes some days, most days, or every day and have smoked in the past 7 days, have an appointment with a dentist or hygienist, NYS resident, speak English, Spanish, Chinese or Russian, and are able to comply with study procedures in the opinion of the principal investigator.

Exclusion Criteria:

* Clinic locations are excluded if the number of unique adult patient visits per week averages less than 100, if the dental director reports that the clinic assists more than 60% of patients with tobacco cessation and if the clinics policies would prohibit the clinic from accepting pay-for-performance funds if randomized to that arm. All sites with less than 3 dental providers will also be excluded.
* Providers are excluded if they do not speak English.
* Patients are excluded if they do not speak English, Spanish, Chinese or Russian, and if they have already completed the patient exit interview during the same intervention phase.

Answer: A