Behavior, knowledge, and attitude of surgeons and patients toward preoperative smoking cessation

Hajjar, Waseem; Alnassar, Sami; Alahmadi, Reem; Almohanna, Shahad M; AlHilali, Sara

doi:10.4103/1817-1737.180021

Cited by 9 publications

(16 citation statements)

References 17 publications

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“…Initiation of smoking cessation was visible in 15.3% of our OCRs, which is a strikingly low number, considering that previous studies have found 58 to 70% of surgeons to advise their patients to quit smoking before surgery [13][14][15][16]. Insufficient training, lack of knowledge, lack of perceived efficacious interventions, and lack of time have proven the most significant smoking cessation barriers for surgeons [13,16,17].…”

Section: Discussionmentioning

confidence: 85%

Weak smoking cessation awareness in primary health care before surgery: a real-world, retrospective cohort study

Gräsbeck

Ekroos²,

Halonen³

et al. 2020

Scandinavian Journal of Primary Health Care

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Objective: Tobacco smoking is a well-established risk factor for postoperative complications. Research on preoperative smoking cessation in primary health care is scarce. Design: This was a retrospective cohort study. Setting: The Stop Smoking before Surgery Project (SSSP) started in Porvoo, Finland, in May of 2016, involving both primary health care and specialized health care. The goals of the project were smoking awareness and preoperative smoking cessation. Subjects: Our study involved 1482 surgical patients operated at Porvoo Hospital between May and December of 2016. Main outcome measures: We studied the recording of smoking status in all patients, and ICD-10 diagnosis of nicotine dependency and the initiation of preoperative smoking cessation in current smokers. Variables were studied from electronic patient records, comparing primary health care referrals and surgical outpatient clinic records. Results: Smoking status was visible in 14.2% of primary health care referrals, and in 18.4% of outpatient clinic records. Corresponding rates for current smokers (n ¼ 275) were 0.0 and 8.7% for ICD-10 diagnosis of nicotine dependence, and 2.2 and 15.3% for initiation of preoperative smoking cessation. The differences between primary health care referrals and outpatient clinic records were statistically significant for all three variables (p .001). Conclusion: In primary health care, very little attention was paid to preoperative smoking cessation. Rates were significantly better at the surgical outpatient clinic, but still low. We could not demonstrate any certain effect of the intervention. Our results call for future research on ways to improve smoking cessation rates. KEY POINTSTobacco smoking is a well-established risk factor for postoperative complications. Research on preoperative smoking cessation in primary health care is scarce. We found weak smoking awareness and weak smoking cessation intervention numbers among both primary and specialized health care doctors. Our results indicate an urgent need for an efficient preoperative smoking cessation model involving both primary and specialized health care. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 85%

Weak smoking cessation awareness in primary health care before surgery: a real-world, retrospective cohort study

Gräsbeck

Ekroos²,

Halonen³

et al. 2020

Scandinavian Journal of Primary Health Care

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“…In our study, 15% of physicians were current smokers, higher than the national average (12.2%) 13 , but slightly less than the prevalence among healthcare professionals found in the western region of KSA in 2015 (18.4%) 34 . Another study assessed attitudes of surgeons practicing in KSA toward preoperative smoking cessation, and found that more than 70% of patients would like to quit smoking after surgery 35 . Almost 70% of surgeons reported that their patients quit before the surgery, however, 58.8% of patients reported not receiving advice to quit.…”

Section: Discussionmentioning

confidence: 99%

“…Almost 70% of surgeons reported that their patients quit before the surgery, however, 58.8% of patients reported not receiving advice to quit. Authors emphasized the importance of training surgeons on the negative effects of smoking on surgery outcomes 35 . Compared to the tobacco prevalence in other countries, prevalence in KSA is lower than the worldwide average (25.0%), however, it is higher than many countries that have made progress in tobacco cessation 36 .…”

Section: Discussionmentioning

confidence: 99%

Physicians’ self-efficacy, beliefs and intentions to provide tobacco cessation services: A cross-sectional study in Riyadh, Saudi Arabia

Elkhadragy¹,

Christ²,

Bashawri³

et al. 2021

Popul. Med.

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INTRODUCTION Prevalence of tobacco use in the Kingdom of Saudi Arabia (KSA) is 12.2% and negatively impacting the health of the population. Diseases such as lung cancer, heart diseases, and poor prognosis of COVID-19 can be prevented by tobacco cessation. Physicians are trusted among patients and therefore are well-positioned to provide tobacco cessation services, however, their attitudes about such services are unknown. Our purpose is to assess attitudes about providing tobacco cessation services among physicians practicing in KSA. METHODS This study is questionnaire-based and of crosssectional design. We applied the Theory of Reasoned Action (TRA) framework to guide our study. Twenty percent (n=25) of primary care centers were randomly selected. A paperbased survey was administered to 291 physicians practicing in the selected primary care centers, each item mapped onto one of the seven TRA constructs. Constructs assessed were: demographics, self-efficacy, knowledge, subjective beliefs, normative beliefs, control beliefs, and intentions to provide tobacco cessation services. Constructs were measured with latent variables, and associations were estimated in a structural equation path model. RESULTS The majority (71%) of physicians reported minimal or no training on tobacco cessation. The average score for tobacco treatment knowledge was 4.09 out of 10 questions. On a scale of 1 to 5, the mean score for intention to provide tobacco cessation services was 3.26. Mean scores for subjective, normative, and control beliefs were 3.45, 3.41, and 3.43, respectively. Mean score for self-efficacy was 3.38. Self-efficacy had a strong influence on intention to provide cessation services via several pathways. CONCLUSIONS Due to lack of prior training among physicians, we recommend delivering future tobacco cessation training. Such training would be effective, given that scores on selfefficacy, beliefs, and intentions, in this study indicate a promising attitude toward the provision of tobacco cessation services.

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“…At the surgeon’s advice, 95.3% of the patients agreed to quit smoking before surgery, 53.6% would quit after surgery, and 70.6% had already quit smoking. 36 Thorndike et al 37 evaluated physician practices regarding the counseling of patients to quit smoking, between 1991 and 1995, and found that, at 65% of visits, physicians asked patients about their smoking status; at 29%, they counseled patients to quit smoking; and, at only 1.3%, they prescribed a specific smoking cessation treatment.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of smoking cessation treatment initiated during hospitalization in patients with heart disease or respiratory disease

et al. 2018

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Objective:To evaluate the effectiveness of a smoking cessation program, delivered by trained health care professionals, in patients hospitalized for acute respiratory disease (RD) or heart disease (HD). Methods:Of a total of 393 patients evaluated, we included 227 (146 and 81 active smokers hospitalized for HD and RD, respectively). All participants received smoking cessation treatment during hospitalization and were followed in a cognitive-behavioral smoking cessation program for six months after hospital discharge. Results:There were significant differences between the HD group and the RD group regarding participation in the cognitive-behavioral program after hospital discharge (13.0% vs. 35.8%; p = 0.003); smoking cessation at the end of follow-up (29% vs. 31%; p < 0.001); and the use of nicotine replacement therapy (3.4% vs. 33.3%; p < 0.001). No differences were found between the HD group and the RD group regarding the use of bupropion (11.0% vs. 12.3%; p = 0.92). Varenicline was used by only 0.7% of the patients in the HD group. Conclusions:In our sample, smoking cessation rates at six months after hospital discharge were higher among the patients with RD than among those with HD, as were treatment adherence rates. The implementation of smoking cessation programs for hospitalized patients with different diseases, delivered by the health care teams that treat these patients, is necessary for greater effectiveness in smoking cessation.

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Behavior, knowledge, and attitude of surgeons and patients toward preoperative smoking cessation

Cited by 9 publications

References 17 publications

Weak smoking cessation awareness in primary health care before surgery: a real-world, retrospective cohort study

Weak smoking cessation awareness in primary health care before surgery: a real-world, retrospective cohort study

Physicians’ self-efficacy, beliefs and intentions to provide tobacco cessation services: A cross-sectional study in Riyadh, Saudi Arabia

Evaluation of smoking cessation treatment initiated during hospitalization in patients with heart disease or respiratory disease

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