Feasibility of collecting computer-facilitated patient-reported tobacco use, interest, and preferences for smoking cessation in an outpatient thoracic surgery and oncology setting

Abstract

INTRODUCTION Effective strategies are needed to facilitate collection of tobacco use information and integrate smoking cessation treatment into the routine care of all high-risk patient populations to improve clinical outcomes. The objective of this study was to establish the feasibility of collecting computer-facilitated patientreported tobacco use, identify patient interest and preferences for smoking cessation in an outpatient thoracic surgery and oncology setting with higher prevalence of tobacco use than the general population. METHODS A brief patient-administered tobacco screening survey was handed out on an iPad in the waiting room of a thoracic surgery and oncology practice setting to sequential patients with varying diagnoses. Tobacco use, household exposure to tobacco, and interest and preferences for smoking cessation treatment were recorded. Descriptive statistics and Pearson's chi-squared test were used for analysis. RESULTS Of the 599 surveys administered, 594 (99%) were completed. Self-reported smoking status included 36.4% (n=218) never smokers, 53.3% (n=319) former smokers, and 10.4% (n=62) current smokers. Among current smokers, 45.2% (n=28) were interested in receiving smoking cessation treatment. Preferences for treatment included: 21.4% (n=6) who wanted Quitline only, 25% (n=7) medication alone, and 53.6% (n=15) combined Quitline plus medication. Current smokers (55.7%, n=34) were more likely to live in households with tobacco exposure compared to those with former (11.4%, n=36) or never smokers (8.3%, n=18) (p<0.0001). CONCLUSIONS Implementing a computer-facilitated system to screen for current smoking and provide smoking cessation services was feasible in the outpatient thoracic surgery and oncology setting. Almost half of the smokers indicated an interest in receipt of smoking cessation treatment. Household exposure was more frequent among current smokers, therefore routine screening for secondhand smoke exposure from other household members is an important consideration in developing smoking cessation treatment plans to mitigate health risks among vulnerable patient populations.

Effectiveness of a computer-facilitated intervention on improving provider delivery of tobacco treatment in a thoracic surgery and oncology outpatient setting: A pilot study

“…Next, a clinical champion was identified who collaborated with the research team to facilitate prescription of cessation medications and integrate tobacco treatment into the workflow. Other strategies used to prepare for implementation were to set up a system to collect tobacco use data and initiate treatment 5 . The system included: 1) delivering a survey on an iPad, 2) linking iPad responses to a patient chart, 3) alerting clinicians to patients who were smoking and their preference for receiving tobacco treatment, and 4) facilitating cessation medication and quitline referral by creation of templates in the electronic health records.…”

“…We provided training to clinical staff to facilitate collecting information about tobacco use. Front desk staff training included administering a tobacco survey through an iPad to patients upon check-in to the clinic, reviewing the message displayed on the iPad when patients returned it to them, and flagging patient charts with their tobacco treatment preferences 5 . The second step of CEASE is to ‘Assist’.…”

“…The administration of an iPad at the time of check-in became part of routine care. A survey was embedded on an iPad which collected tobacco use data and identified patient preferences for tobacco treatment services 5 . Patients completed this survey within one to five minutes and returned the iPad to the front desk staff.…”