A. Radakrishnan1, J. K. Johnson1, J. Coughlin1, R. Love1, D. Odell1 1Feinberg School Of Medicine – Northwestern University,Chicago, IL, USA
Introduction: Tobacco use is the greatest preventable cause of death and disease in the United States, representing a large medical and financial burden nationally. Despite recommendations from the Centers for Disease Control and Prevention (CDC), the United States Preventive Services Task Force, and major professional societies that all providers provide smoking cessation counseling, the delivery and efficacy of these interventions is inconsistent. We conducted a series of standardized interviews with providers caring for patients with lung cancer to identify important barriers and facilitators to the delivery of smoking cessation counselling.
Methods: We performed a series of interviews with members of the thoracic oncology program at our institution. A total of fourteen interviews were conducted, ranging from 15 minutes to 45 minutes in duration, with provider stakeholders including thoracic surgeons (n=3), interventional pulmonologists (n=1), medical oncologists (n=3), radiation oncologists (n=2), and nurses from the various clinics (n=5). Interviews surveyed providers about the details of their role within care teams, smoking cessation interventions currently offered in their clinics, the providers’ perspectives on barriers to successful smoking cessation, as well as opportunities for improvement. Transcripts and audio recordings were qualitatively analyzed for themes to establish the most important domains to consider when creating a successful and feasible smoking cessation program.
Results: Providers emphasized 5 main domains that impact their delivery of smoking cessation counseling: time pressure, clinical history, resource knowledge, lack of provider education, and inadequate follow-up. All interview participants spend time discussing smoking cessation with their patients and realize the great importance of a smoking cessation counseling, but describe a need for a brief intervention. Providers also noted the diagnosis of lung cancer provided a powerful motivation for the patient to quit smoking. Further, those participants whose practice involved procedural interventions felt that obtaining the procedure was particularly motivating.
Conclusion: All providers recognize the need for more efficient and consistent smoking cessation counseling intervention. All agreed that a brief intervention can be successfully delivered and would be welcomed in their respective clinics.