Tobacco treatment TrAining Network in Crete (TiTAN-Crete): protocol for a controlled before-after study
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Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario,Canada
Faculty of Medicine,University of Ottawa,Ottawa, Ontario, Canada
Submission date: 2016-02-05
Final revision date: 2016-06-13
Acceptance date: 2016-06-22
Publication date: 2016-06-29
Corresponding author
Charis Girvalaki   

Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, 71500 Heraklion, Greece
Tob. Prev. Cessation 2016;2(June):67
Rates of tobacco use in Greece are among the highest in Europe and are responsible for an enormous burden of chronic disease and death. A large proportion of tobacco users report an interest in quitting. Family medicine practices have been identified as important settings for identifying tobacco users, delivering advice to quit smoking, and providing tobacco treatment interventions. The 5A’s (ask, advice, assess, assist, arrange) schema is an evidence-based model for addressing tobacco use in clinical settings. The rates at which primary care clinicians in Greece address tobacco use in their practice is unknown but, as in other countries, is understood to be sub-optimal. This paper describes the rationale, design, and protocol for a pre/post, controlled study to compare the effectiveness of a smoking cessation intervention delivered in primary care practices in Heraklion, Greece. The TiTAN-Crete intervention includes a 1-day tobacco treatment training program, dissemination of provider and patient resources and two booster training sessions. Participating providers and a cross-sectional sample of patients from their practices, will be surveyed. Outcome measures include changes in provider attitudes and beliefs, perceived behavioral control, intentions, and barriers related to smoking cessation treatment delivery. Rates at which providers deliver tobacco treatment to patients will be measured by patient report of 5As delivery. Multi-level modeling will be used to examine the effects of the intervention. This study will lead to a better understanding of how to best assist clinicians in Greece to enhance the rates at which smoking cessation treatments are delivered to smokers.
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