Dataset Information

Thoracic Surgeons' Beliefs and Practices on Smoking Cessation Before Lung Resection.

ABSTRACT:

Background

Smoking is a risk factor for complications after lung resection. Our primary aim was to ascertain thoracic surgeons' beliefs and practices on smoking cessation before lung resection.

Methods

An anonymous survey was emailed to 846 thoracic surgeons who participate in The Society of Thoracic Surgeons General Thoracic Surgery Database.

Results

The response rate was 23.6% (n = 200). Surgeons were divided when asked whether it is ethical to require that patients quit smoking (yes, n = 96 [48%]) and whether it is fair to have their outcomes affected by patients who do not quit (yes, n = 87 [43.5%]). Most do not require smoking cessation (n = 120 [60%]). Of those who require it, the most common required period of cessation is 2 weeks or more. Most believe that patient factors are the main barrier to quitting (n = 160 [80%]). Risk of disease progression (39% vs 17.5%, p = 0.02) and alienating patients (17.5% vs 8.8%, p = 0.04) were very important considerations of those who do not require smoking cessation versus those who do. Only 19 (9.5%) always refer to a smoking cessation program and prescribe nicotine replacement therapy and even fewer, 9 (4.5%), always refer to a program and prescribe medical therapy.

Conclusions

Thoracic surgeons are divided on their beliefs and practices regarding smoking cessation before lung resection. Most believe patient factors are the main barrier to quitting and have concerns about disease progression while awaiting cessation. Very few surgeons refer to a smoking cessation program and prescribe nicotine replacement therapy or medical therapy.

SUBMITTER: Marrufo AS

PROVIDER: S-EPMC11292109 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Thoracic Surgeons' Beliefs and Practices on Smoking Cessation Before Lung Resection.

Marrufo Angelica S AS Kozower Benjamin D BD Tancredi Daniel J DJ Nuño Miriam M Cooke David T DT Pollock Brad H BH Romano Patrick S PS Brown Lisa M LM

The Annals of thoracic surgery 20181223 5

<h4>Background</h4>Smoking is a risk factor for complications after lung resection. Our primary aim was to ascertain thoracic surgeons' beliefs and practices on smoking cessation before lung resection.<h4>Methods</h4>An anonymous survey was emailed to 846 thoracic surgeons who participate in The Society of Thoracic Surgeons General Thoracic Surgery Database.<h4>Results</h4>The response rate was 23.6% (n = 200). Surgeons were divided when asked whether it is ethical to require that patients quit ...[more]

PMID: 30586576

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Project description:ObjectiveSmoking, with a prevalence of about 25%-30% in Switzerland, is proven to cause major systemic, avoidable diseases including lung cancer, increasing societies morbidity and mortality. Diverse strong quitting smoking recommendations have been made available providing advice facilitating smoking cessation globally. In other European countries like Germany, clinical practice guidelines for smoking cessation services have been implemented. However, in Switzerland, there is still no national consensus on a comprehensive smoking cessation program for lung cancer patients nor on the adequate provider. Our primary aim was to assess the current status of smoking cessation practice among specialists, mainly involved in lung cancer care, in Switzerland in order to uncover potential shortcomings.Material and methodsA self-designed 14-items questionnaire, which was reviewed and approved by our working group consisting of pneumologists and thoracic surgeons, on demographics of the participants, the status of smoking cessation in Switzerland and specialists' opinion on smoking cessation was sent to thoracic surgeons and pneumologists between January 2024 and March 2024 via the commercially available platform www.surveymonkey.com. Data was collected and analysed with descriptive statistics.ResultsSurvey response rate was 22.25%. Smoking cessation was felt to positively affect long term survival and perioperative outcome in lung cancer surgery. While 33 (37.08%) physicians were offering smoking cessation themselves usually and always (35.96%), only 12 (13.48%) were always referring their patients for smoking cessation. Patient willingness was clearly identified as main factor for failure of cessation programs by 63 respondents (70.79%). Pneumologists were deemed to be the most adequate specialist to offer smoking cessation (49.44%) in a combination of specialist counselling combined with pharmaceutic support (80.90%).ConclusionThe development of Swiss national guidelines for smoking cessation and the implementation of cessation counselling in standardized lung cancer care pathways is warranted in Switzerland to improve long-term survival and perioperative outcome of lung cancer patients.

Project description:BackgroundGeneral practitioners (GPs) play an important role in providing patients who smoke with health information, support and treatment to encourage them to quit smoking. Despite conflicting evidence on the effectiveness of electronic cigarettes (e-cigarettes) as a smoking cessation aid, there is growing interest in the role e-cigarettes might play as an alternative to smoking tobacco. This systematic review aims to synthesise evidence from qualitative, quantitative and mixed-methods studies of the knowledge, attitudes, beliefs and social norms of GPs with respect to the use of e-cigarettes as smoking cessation aids.MethodsThis study adhered to the PRISMA guidelines. Studies from MEDLINE, CINAHL, SCOPUS, PsycINFO, EMBASE and grey literature were searched. Two independent reviewers screened abstracts and full-text articles to identify studies that met the inclusion criteria. A data extraction form was used to extract relevant data from included papers and were quality appraised using the MMAT checklist. A PRISMA flow diagram was used to record the flow of papers and reasons for exclusion. Studies were included if they collected quantitative, qualitative or mixed methods data to determine knowledge, attitudes, beliefs and social norms of GPs for use of e-cigarettes as smoking cessation aids.ResultsA total of 4056 abstracts were screened and 25 articles were included. Our findings showed that GPs had mixed views on recommending e-cigarettes as a smoking cessation aid. Some GPs were optimistic and had recommended e-cigarettes to their patients. Others were reluctant and disagreed that e-cigarettes are an effective method to quit smoking. Most GPs lacked knowledge and confidence in having discussions with patients around e-cigarette safety and efficacy as smoking cessation alternatives.ConclusionThis systematic review shows there are mixed views on e-cigarettes as smoking cessation aids. Clear guidance on the role of e-cigarettes is needed to inform and upskill GPs about e-cigarettes for smoking cessation.Prospero registrationCRD42021227612.

Project description:IntroductionWe compared smoking cessation outcomes between those who used a pharmacist-led community-based smoking cessation intervention and those who did not, prior to total joint replacement (TJR) surgery. Also, we examined intervention characteristics (e.g. number/duration of sessions attended, recommended therapy) and smoking cessation outcomes.MethodsThis prospective evaluation was nested within a comparative study from a centralized clinic that prepares over 3000 patients annually for TJR and focused on participants referred to the community-based smoking cessation program preoperatively. Pharmacists offered an individualized evidence-based intervention and collected visit, duration and intervention data. Smoking cessation, the primary outcome, was ascertained independently of participating pharmacists at 6 weeks post-operative using exhaled CO monitoring and at 6 months post-recruitment via telephone interview.ResultsOf 286 eligible candidates, 104 agreed to participate, with one subsequently withdrawing (n=103). At 6 weeks post-operatively, 66/103 (64%) participants returned for study re-assessment while 63/103 (61%) participants completed the post-recruitment interview at 6 months; non-respondents to study follow-up were considered smokers. Of 103 participants, 58 (56%) consulted with a pharmacist; those who did not consult a pharmacist (n=45) were slightly younger (p=0.02) with significantly higher CO level (p=0.02) on study entry. Validated 7-day point prevalence abstinence (PPA) at 6 weeks post-operative was 11/58 (19%) in pharmacist-compliant participants compared to 2/45 (4%) in non-compliant participants (p=0.04). At 6 months post-recruitment, 19/58 (33%) pharmacistcompliant participants self-reported a 7-day PPA compared to 2/45 (4%) by non-compliant participants (p<0.001). For pharmacist-compliant participants, 33/58 (54%) saw the pharmacist 4 times; the mean overall pharmacist time was 71.8±24.4 minutes/patient with 26/58 (45%) and 19/58 (33%) prescribed nicotine replacement therapy and varenicline, respectively, and 13/58 (22%) not using medication; post hoc analysis suggested varenicline was marginally more effective for smoking cessation than no medication (p=0.04).ConclusionsCommunity-based pharmacist-led smoking cessation programs are an effective addition to usual preoperative care for smokers awaiting elective TJR. Using existing community resources led to higher smoking cessation rates in smokers waiting for TJR relative to those not using these resources.

Dataset Information

Thoracic Surgeons' Beliefs and Practices on Smoking Cessation Before Lung Resection.

Background

Methods

Results

Conclusions

Publications

Thoracic Surgeons' Beliefs and Practices on Smoking Cessation Before Lung Resection.

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