A Retrospective Review of Pilot Outcomes from an Out-patient Tobacco Treatment Programme Within Cardiology Services

Abstract

I ntroduction: Due to the challenging nature of tobacco addiction, individuals with cardiac conditions often continue to smoke at high rates (up to 62%), even after experiencing life-threatening events. Aims: This study examines pilot outcomes of a longitudinal Smoking Cessation Clinic (SCC) within cardiology services. Methods: This study is based on a retrospective review of the charts of 117 participants of the SCC (between September 2010 and May 2012). The main outcome of interest is self-reported 7-day pointprevalence of smoking abstinence verified by expired CO level. A secondary outcome was smoking reduction, defined as consuming 50% (or lower) than the baseline number cigarettes in the past week. Results: Thirty-five per cent of participants achieved smoking cessation, whereas 42.1% reduced their cigarette consumption. In multivariate regression analyses, salient predictors of smoking cessation included being male and a greater length of visiting the smoking cessation clinic. Conclusions: Providing evidence-based approaches to tobacco treatment within cardiology services is feasible and well received by patients with cardiac and other co-morbidity. The modest outcomes from this pilot study support the need for tobacco treatment in hospital cardiology settings. Such interventions may aid in reducing the disproportionate burden of tobacco-related disease among smokers with medical co-morbidity.

Smoking cessation outcomes of referral to a specialist hospital outpatient clinic

“…A detailed description of the SCC program has been provided elsewhere . In brief, the SCC recommends pharmacotherapy (which includes nicotine replacement therapy [NRT] [nicotine gum, patch, lozenge, inhaler, or oral spray] and oral medications [varenicline or buproprion SR]), individual counseling (concise, deliberate advice using the principles of motivational interviewing), and information for referral to a government funded telephone “quit line” and other community resources for tobacco treatment.…”

Smoking Cessation Clinic, Hospital’s Participation in Supporting a Quit Smoking Program: A Systematic Review

“…It decreases mortality by 36%, non-fatal reinfarction by 32%, and repeated coronary artery bypass graft rates over 50% [5,6].…”

“…Smoking is preventable [1,4,5]. Many factors affect tobacco quit rate [3], such as intensive counselling intervention when provided to all hospitalized smokers, regardless of admitting diagnosis [6].…”

“…Nonadherence to medications and counselling is common and reduces the chances that smoking cessation will be successful [9]. With the challenges and barriers facing such patients in smoking cessation, it is important to provide accessible and individualized tobacco treatment for these patients at point of contact with healthcare services [5].…”

“…This study is based on a retrospective review of the charts of 117 participants of the SCC being observed for 1 year and eight months period (September 2010 to May 2012). The result is 35% of participants achieved smoking cessation, whereas 42.1% reduced their cigarette consumption[5]. Given the significant morbidity and mortality related to smoking, it is crucial that hospitals provide smoking cessation services at point-of-care.…”