An integral Pro-Active Multicomponent Approach (PAMA) to
optimize and tailor smoking cessation strategies for the
primary health care (PHC) setting

The PAMA project (the ProActive Multicomponent Approach) is aimed at developing and evaluating an intervention (the StopWijzer) aimed at motivating smokers to quit smoking and making use of effective cessation methods. The smoker will be supported by the practice assistant (POH) or General Practitioner. The POH will inform the smoker about the available cessation methods and by talking together, a choice will be made for a cessation method that best suits the individual smoking patient. Examples of cessation methods are behavioral (personal counseling, eHealth, telephone counseling or group counseling), but also nicotine replacement agents (such as patches) or pharmacological agents (such as varenicline). To ensure that the smoker and practice supporter gain sufficient knowledge about the different options, a tool will be developed for both the smoker and the POH. To increase the final implementation and adoption, close cooperation with smokers, general practitioners and POHs were initiated. For example, an extensive needs assessment was conducted through a Delphi study and several interview rounds. Based on this needs assessment and scientific literature, an intervention has been developed that has been tested by means of a pilot study under 13 general practices. The pilot study has demonstrated the added value of the intervention within the field. The final intervention will be developed on the basis of the feedback from the pilot study and will be tested through an effectiveness study accompanied by an economic analysis. The project will be concluded with an appreciation and adoption study.

HYPOTHESES: We hypothesize that the PAMA condition in comparison to the Usual Care condition will:

2. Lead to more high risk smokers engaging to quit
3. Lead to more informed decision to quit smoking by smoking patients
4. Lead to more evidence based smoking strategies chosen by smoking patients
5. Be more effective to realize smoking cessation in smoking patients
6. Be more appreciated by smoking patients<
7. Be more cost-effective
8. Is appreciated by GPs, PNs and other stakeholders
9. Be more likely to become adopted in the GP setting

baseline questionnaire and six and twelve month follow-up questionnaire

The StopWijzer counseling method including supporing materials (online and on paper).