“…System approaches to improving smoking cessation services in clinical settings have included (a) training of physicians (Cornuz et al, 1997;Richmond, Mendelsohn, & Kehoe, 1998;Swartz, Cowan, DePue, & Goldstein, 2002), (b) including smoking status as a vital sign (Fiore et al, 1995;Robinson, Laurent, & Little, 1995), (c) staff training and educational materials (Lancaster, Silagy, & Fowler, 2004;Pine, Sullivan, Sauser, & David, 1997;Solberg, Maxwell, Kottke, Gepner, & Brekke, 1990), (d) assignment of smoking cessation interventions to job descriptions of professionals other than physicians or to teams (Hollis et al, 2000;Hollis, Lichtenstein, Vogt, Stevens, & Biglan, 1993), (e) chart reminders used alone (Chang, Zimmerman, & Beck, 1995) or with other strategies such as free nicotine replacement (Cohen et al, 1987), and (f) reduced or reimbursed costs for smoking cessation services Curry, Grothaus, McAfee, & Pabiniak, 1998;Doescher et al, 2002;. A multicomponent approach that included prioritization of prevention objectives, quality management techniques, and attention to influences on service delivery at the practice, organizational, and community levels was effective (Thompson et al, 1995).…”