domingo, 1 de agosto de 2010

Research Activities, August 2010: Outcomes/Effectiveness Research: Thoracic surgeons can help patients stop smoking with a brief smoking cessation program



Outcomes/Effectiveness Research
Thoracic surgeons can help patients stop smoking with a brief smoking cessation program

Visits to a thoracic surgeon can be a productive time for helping patients who smoke to quit, according to a pilot study at a thoracic surgery clinic. The researchers found that a 10-minute smoking cessation intervention produced a quit rate at 3 months of 35 percent (14 of 40 patients). Half of the patients (20 of 40) used tobacco-cessation medication, including buproprion SR; nicotine gum or inhaler; or the nicotine patch. Only three of the patients (7.5 percent) called a toll-free quitline, but all three had quit smoking (for at least 7 days) at the 3-month follow-up.

Nineteen patients returned for an office visit at 3 months and verified their quitting status by measurement of exhaled carbon monoxide (CO). All 9 who said they had quit, and all 10 who had said they still smoked, had their status confirmed by the CO measurement. The two patient characteristics that had the strongest association with quitting smoking were having malignant disease (4.2 times more likely to quit) and being the only smoker in their household (6.1 times more likely to quit).

The study participants were recruited from adults smoking more than 5 cigarettes per week who were seen at the University of Virginia thoracic surgery clinic from January to December 2008. The participants were either contemplating or trying to quit smoking. All of the participating patients had a brief (10 minutes or less) office intervention with a thoracic surgeon and a clinical research nurse. The intervention included discussing the patient's smoking history, previous attempts to quit, and the current motivation for quitting. The patients were offered pharmaceutical tobacco dependence treatment, use of a free telephone quitline, and related printed materials. Followup was either in person, at the 3-month postsurgical visit, or by a telephone survey at 3 months. The researchers caution that more studies need to be done to confirm the effectiveness of the intervention. The study was funded in part by the Agency for Healthcare Research and Quality (HS18049).

More details are in "A thoracic surgeon-directed tobacco cessation intervention," by Benjamin D. Kozower, M.D., M.P.H., Christine L. Lau, M.D., Jennifer V. Phillips, R.N., and others in the March 2010 Annals of Thoracic Surgery 89(3), pp. 926-930.

Research Activities, August 2010: Outcomes/Effectiveness Research: Thoracic surgeons can help patients stop smoking with a brief smoking cessation program

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