Structured smoking cessation training for health professionals on cardiology wards: a prospective study

Raupach, Tobias; Falk, Jan; Vangeli, Eleni; Schiekirka, Sarah; Rustler, Christa; Grassi, Maria Caterina; Pipe, Andrew; West, Robert

doi:10.1177/2047487312462803

Cited by 36 publications

(40 citation statements)

References 12 publications

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“…The implementation of cost-effective measures to prevent smoking in adolescents and, moreover, the sensitization of prospective physicians to tobacco-attributable diseases, tobacco prevention, and improved communication of these issues in medicine, is addressed by the program [5,9,44,45]. …”

Section: Discussionmentioning

confidence: 99%

“…After multiple failed quit attempts, however, many smokers end up with tobacco-related diseases that physicians are unable to cure [2]. Despite the fact that effectiveness of inpatient smoking cessation was demonstrated in major trials [3] and was implemented in guidelines of almost all medical specialties [4], research has shown that physicians in Germany lack both the motivation (eg, role incongruence as a major barrier [5,6]) and education to deliver smoking cessation advice [5-8], especially before the onset of chronic disease [6]. The issue of undertreatment of tobacco use by physicians is known on a global scale [9,10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial

Brinker¹,

Owczarek²,

Seeger³

et al. 2017

J Med Internet Res

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BackgroundMore than 8.5 million Germans suffer from chronic diseases attributable to smoking. Education Against Tobacco (EAT) is a multinational network of medical students who volunteer for school-based prevention in the classroom setting, amongst other activities. EAT has been implemented in 28 medical schools in Germany and is present in 13 additional countries around the globe. A recent quasi-experimental study showed significant short-term smoking cessation effects on 11-to-15-year-old adolescents.ObjectiveThe aim of this study was to provide the first randomized long-term evaluation of the optimized 2014 EAT curriculum involving a photoaging software for its effectiveness in reducing the smoking prevalence among 11-to-15-year-old pupils in German secondary schools.MethodsA randomized controlled trial was undertaken with 1504 adolescents from 9 German secondary schools, aged 11-15 years in grades 6-8, of which 718 (47.74%) were identifiable for the prospective sample at the 12-month follow-up. The experimental study design included measurements at baseline (t1), 6 months (t2), and 12 months postintervention (t3), via questionnaire. The study groups consisted of 40 randomized classes that received the standardized EAT intervention (two medical student-led interactive modules taking 120 minutes total) and 34 control classes within the same schools (no intervention). The primary endpoint was the difference in smoking prevalence from t1 to t3 in the control group versus the difference from t1 to t3 in the intervention group. The differences in smoking behavior (smoking onset, quitting) between the two groups, as well as gender-specific effects, were studied as secondary outcomes.ResultsNone of the effects were significant due to a high loss-to-follow-up effect (52.26%, 786/1504). From baseline to the two follow-up time points, the prevalence of smoking increased from 3.1% to 5.2% to 7.2% in the control group and from 3.0% to 5.4% to 5.8% in the intervention group (number needed to treat [NNT]=68). Notable differences were observed between the groups for the female gender (4.2% to 9.5% for control vs 4.0% to 5.2% for intervention; NNT=24 for females vs NNT=207 for males), low educational background (7.3% to 12% for control vs 6.1% to 8.7% for intervention; NNT=30), and migrational background (students who claimed that at least one parent was not born in Germany) at the 12-month follow-up. The intervention appears to prevent smoking onset (NNT=63) but does not appear to initiate quitting.ConclusionsThe intervention appears to prevent smoking, especially in females and students with a low educational background.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial

Brinker¹,

Owczarek²,

Seeger³

et al. 2017

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…7 However, findings from Germany suggest that physicians often fail to adhere to these guidelines, 8 and even following the implementation of standard operating procedures for the care of smokers hospitalized with cardiovascular disease, the proportion of patients who recalled having received any counseling was well below 50%. 9 Similarly, suboptimal rates of smoking status documentation and counseling activity have been reported for general practice across Europe. 10 …”

Section: Introductionmentioning

confidence: 99%

Structured Smoking Cessation Training for Medical Students: A Prospective Study

Herold

Schiekirka

Brown

et al. 2016

NICTOB

Self Cite

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Introduction:Physician adherence to guideline recommendations regarding the provision of counseling and support for smokers willing to quit is low. A lack of training during undergraduate medical education has been identified as a potential cause. This prospective intervention study evaluated a novel teaching module for medical students.Methods:As part of a 6-week cardiovascular course, 125 fourth-year undergraduate medical students received a multimodal and interactive teaching module on smoking cessation, including online learning material, lectures, seminars, and practical skills training. Short- and medium-term effects on knowledge, skills, attitudes, and self-reported practice were measured using written examinations and an objective structured clinical examination at the end of the module and 6 months later. Results were compared to data obtained from a historical control cohort (n = 70) unexposed to the intervention.Results:At the 6-month follow-up, scores in the knowledge test were significantly higher in the intervention than the control group (61.1% vs. 51.7%; p < .001). A similar pattern was observed in the objective structured clinical examination (71.5% vs. 60.5%; p < .001). More students in the intervention than control group agreed that smoking was a chronic disease (83.1% vs. 68.1%; p = .045). The control group was more likely to report recording smoking status (p = .018), but no group difference was detected regarding the report of advising to quit (p = .154).Conclusions:A novel teaching module for undergraduate medical students produced a sustained learning outcome in terms of knowledge, skills, and attitudes but not self-reported practice.Implications:Studies across the world have identified considerable knowledge gaps and deficits in practical training with regard to smoking cessation counseling in undergraduate medical students. This paper describes a teaching intervention informed by current recommendations for the design of educational activities aimed at enabling medical students to deliver adequate behavior change counseling. The teaching module was tailored to the needs of a specific healthcare system. Given its effectiveness as demonstrated in this prospective study, a rollout of this intervention in medical schools might have the potential to substantially improve medical students’ knowledge, skills, and attitudes in relation to smoking cessation counseling.

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“…Lack of motivation, opportunity, and capacity among healthcare staff are some of the barriers in delivering cessation interventions [97,100,101]. Nurses and doctors are often not motivated to deliver cessation interventions as they perceive it to be outside their roles.…”

Section: Just Focus On Treating the Conditionmentioning

confidence: 99%

Smoking Cessation in Long-Term Conditions: Is There “An Opportunity in Every Difficulty”?

Siddiqi

Dogar

Siddiqi

2013

International Journal of Population Research

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Introduction. Smoking plays a causal role in several long-term conditions and worsens their outcomes. Focusing on six such conditions, we present a narrative review of seminal studies on the prevalence and impact of continued tobacco use on these conditions; the effectiveness of cessation interventions; the extent to which patients receive these interventions, and barriers to providing and taking up these interventions. Methods. A conceptual framework was used to identify questions for a series of focused literature reviews. Findings were synthesized and the literature was examined to identify themes common across these conditions. Results. Smoking prevalence is either similar or higher in patients with established long-term conditions compared to the general population. Continued smoking accelerates disease progression, worsens outcomes, and risks poor treatment compliance or further complications. There is strong evidence for the effectiveness of cessation interventions in achieving smoking abstinence. Despite this, only a small proportion of patients receive such interventions. Important barriers to uptake include concerns about weight management and drug safety, higher nicotine dependency and codependency, comorbidity, and misperceptions about the benefits of cessation. Conclusion. The benefits of offering smoking cessation in patients with long-term conditions are far too great for it to remain of a low priority.

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Structured smoking cessation training for health professionals on cardiology wards: a prospective study

Abstract: Introduction of a set of standard operating procedures for smoking cessation advice was effective with physicians but not nurses. Analysis of barriers to implementation highlighted lack of motivation rather than capability or opportunity as a major factor that would need to be addressed.

Cited by 36 publications

References 12 publications

A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial

A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial

Structured Smoking Cessation Training for Medical Students: A Prospective Study

Smoking Cessation in Long-Term Conditions: Is There “An Opportunity in Every Difficulty”?

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