Systematic Review of Clinician-Reported Barriers to Provision of Smoking Cessation Interventions in Hospital Inpatient Settings

Abstract

B ackground: Although the hospital inpatient setting arguably provides an ideal opportunity to engage patients in smoking cessation interventions, this is done infrequently. We therefore aimed to systematically review the perceived barriers to the implementation of smoking cessation interventions in the hospital inpatient setting. Methods: A systematic literature search was conducted specific to hospital-based healthcare workers' perceived barriers to implementing smoking cessation interventions. Reported barriers were categorised using the capability, opportunity and motivation (COM-B) framework. Results: Eighteen studies were selected for inclusion, which consisted of cross-sectional surveys and interviews. The most commonly identified barrier in capability was lack of knowledge (56% of studies); in Opportunity, it was a lack of time (78%); while in Motivation, a lack of perceived patient motivation to quit smoking (44%). Seventeen other barriers were also endorsed, but less frequently. Conclusion: Healthcare workers report a plethora of barriers to providing smoking cessation interventions in hospital settings, which cover all aspects of the COM-B framework. These impediments need to be addressed in a multidisciplinary approach, at clinical, educational, and administrative levels, to improve intervention provision.

A Systematic Review Protocol of the Barriers to Both Physical Activity and Obesity Counselling in the Secondary Care Setting as Reported by Healthcare Providers

“…Similar to previous research in the provision of brief smoking cessation advice [19], this systematic review will be beneficial not only to practicing healthcare providers, but also the educational and managerial staff of secondary care facilities, as it may highlight the need for further training to fill gaps in the provision of preventive healthcare.…”

“…The participants will be all healthcare professionals, the intervention will be brief advice or counselling, there will be no comparators and the outcome will be barriers that have been noted by the healthcare providers. The barriers will be grouped using the COM-B model of behaviour (capability, opportunity and motivation), allowing readers to easily identify how many times a particular barrier has been reported [19]. The protocol will be conducted according to the PRISMA-P protocol (see Appendix A) [20].…”

Implementation of a Quit Smoking Programme in Community Adult Mental Health Services–A Qualitative Study

“…Conflicting priorities and a lack of prioritizing smoking cessation support as part of staff workload has previously emerged as a barrier among HCPs in Ireland and internationally (46–48). As well as in relation to mental health services more specifically especially in the context of outpatient settings (38).…”

Smoking behaviours of Hong Kong Chinese hospitalised patients and predictors of smoking abstinence after discharge: a cross-sectional study

“…In particular, healthcare professionals should be given relevant training to enhance their self-efficacy and confidence in promoting smoking cessation to patients. A systematic review indicated numerous barriers to provision of smoking cessation interventions in hospital settings 28. More studies should be conducted to identify barriers specific to the Hong Kong Chinese context.…”