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Provision of comprehensive smoking cessation care to surgical patients in Australia: the case for routine clinical delivery
John Wiggers, Director, Hunter New England Population Health,
New South Wales, Australia
Abstract
Introduction:
Surgical patients can reduce their risk of post operative complications and chronic disease if they quit smoking. This paper describes the findings of studies examining the feasibility, efficacy, cost and acceptability of computer based smoking cessation care delivered to surgical patients.
Methods:
A randomised controlled trial was conducted of a smoking cessation intervention delivered in a hospital that involved computerized: screening of patient smoking status, provision of smoking cessation counseling, provision of self help materials, prompting of clinician brief advice, prescribing of NRT, and referral to a Quitline.
Results:
The screening program was found to accurately identify smokers (sensitivity 93%, specificity 95%). In a controlled trial, the delivery of each component of cessation care was significantly greater in the intervention group relative to controls. Further, the intervention significantly increased patient cessation prior to admission (56% vs 73%) and at a 3 month post-discharge
(5% vs 18%) for nicotine dependent patients. All components of care were found to be acceptable to patients and staff and the intervention was relatively inexpensive to deliver.
Conclusions:
Despite the challenges for clinicians to routinely provide smoking cessation care to patients, such care can be provided to patients in a way which is feasible, efficacious and acceptable to both patients and staff.
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About the presenter
Dr John Wiggers is an Associate Professor in the School of Medicine and Public Health, University of Newcastle, Australia, and is the Director, Hunter New England Population Health, a health service unit responsible for the provision of health protection, health promotion and surveillance services to the 8,000,000 residents of the Hunter New England community. John has over twenty years experience in the field of population health research and practice, and has a particular interest in the prevention of tobacco and alcohol-related harm through the modification of care and service delivery systems.
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