1
|
Nagasawa T, Saito J, Odawara M, Kaji Y, Yuwaki K, Imamura H, Nogi K, Nakamura M, Shimazu T. Smoking cessation interventions and implementations across multiple settings in Japan: a scoping review and supplemental survey. Implement Sci Commun 2023; 4:146. [PMID: 37993908 PMCID: PMC10666296 DOI: 10.1186/s43058-023-00517-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/28/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Smoking is the leading risk factor for death worldwide. In Japan, although several evidence-based interventions (EBIs) for smoking cessation have been disseminated or adopted, there is a gap between scientific evidence and the actual implementation. This scoping review aimed to describe the knowledge gaps in local-level smoking cessation interventions in Japan, their implementation outcomes, implementation barriers and facilitators, and the use of implementation strategies. METHODS This study comprised two approaches: (1) a comprehensive scoping review of primary and grey literature, and (2) a supplemental survey of organizations in the grey literature. For the scoping review, we included original studies or reports on smoking cessation interventions targeting adults aged 18 years and older, or providers of cessation support at various settings (community, workplace, school, and clinical settings) in Japan. The extracted data included basic characteristics, intervention categories, implementation outcomes, factors influencing implementation, and implementation strategies for each intervention. Responses to the supplemental survey were extracted same used for the scoping review. To gain a deeper understanding, semi-structured interviews were conducted with some of the organizations in the survey. RESULTS A total of 600 interventions with 691 intervention components, based on EBIs in the 2020 US Surgeon General Report, from 498 articles were included in the data extraction; 32 of the 88 organizations responded to the survey. Regarding the overall knowledge about smoking cessation intervention components, behavioral counseling, and cessation medication in clinical settings were mostly reported (34.7%). Implementation outcomes were measured in 18 articles (3.0%) and penetration was mostly reported. Regarding influential factors, "available resources," and "knowledge and beliefs about the intervention" for barriers, and "relative priority" for facilitators were mostly reported. Implementation strategies were measured in 29 articles (4.8%), and "Train and educate stakeholders" was mostly reported. CONCLUSIONS Most EBIs reported in the Japanese literature included smoking cessation treatments in clinical settings. While a few articles focused on the implementation indicators in Japan, significant knowledge and experience were extracted from the grey literature, especially in the workplace and community settings. Future research should focus more on implementation to reduce the knowledge gap regarding smoking cessation interventions.
Collapse
Affiliation(s)
- Tomomi Nagasawa
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Yuki Kaji
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Keiichi Yuwaki
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
- Department of Cancer Epidemiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Haruhiko Imamura
- Graduate School of Health and Nutrition Sciences, The University of Nagano, Nagano City, Nagano, Japan
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Ota-Ku, Tokyo, Japan
| | - Kazuya Nogi
- Department of Environmental and Occupational Health, Toho University Graduate School of Medicine, Ota-Ku, Tokyo, Japan
| | - Masakazu Nakamura
- Health Promotion Research Center, Institute of Community Medicine, Japan Association for Development of Community Medicine, Chiyoda-Ku, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan.
| |
Collapse
|
2
|
Gavilan E, Fernández E, Minguell J, Trilla E, Zuriguel-Pérez E, Martínez C. Efficacy of Presurgical Interventions to Promote Smoking Cessation: A Systematic Review. Anesth Analg 2023; 136:43-50. [PMID: 36534716 DOI: 10.1213/ane.0000000000006240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aim of this study was to evaluate the efficacy of presurgical interventions for promoting smoking cessation in terms of achieving smoking abstinence and reducing surgical complication rates. A systematic review of randomized clinical trials (RCTs) published from March 2009 to April 2021 was performed following the PRISMA guidelines. References were found in MEDLINE (via PubMed), Web of Science (WOS), and Cumulative Index to Nursing and Allied Health Literature (CINAHL). RCTs comparing the efficacy of a smoking cessation program directed at an intervention group (IG) versus the usual intervention or another directed at a control group (CG) were included. No language restrictions were applied in the search. All approaches to smoking cessation were admitted (face-to-face, telephone, group, individual, multicomponent, etc.), as were all methods for assessing abstinence, follow-up times, surgical specialties, definitions of smokers, and all types of surgical complications. Four hundred forty-four references were pulled out, and 79 duplicates were discarded. We excluded 346 records that were after application of the inclusion/exclusion criteria. In addition to the remaining 19 articles, 1 article obtained from citation searches was also assessed. We finally included 11 original articles in this systematic review, corresponding to 9 studies, because 2 of the RCTs had 2 different articles referring to different aspects of the same study. The results showed long-term postoperative (6 to 12 months) abstinence rates between 25.0% and 36.4% in RCTs with intensive multicomponent interventions, versus rates about 13.0% in brief interventions. Two multicomponent interventions obtained significant improvements regarding the reduction of short-term postoperative surgical complications. In conclusion, presurgical multicomponent smoking cessation interventions are more effective than brief interventions in terms of achieving abstinence and reducing surgical complications. The follow-up time and the intensity of the interventions were predictors of dropout.
Collapse
Affiliation(s)
- Eva Gavilan
- From the Surgical Area, Vall d´Hebron University Hospital, Barcelona, Spain.,International University of Catalonia, Barcelona, Spain.,Multidisciplinary Nursing Research Group, Vall d´Hebron Research Institute, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Science, Bellvitge Campus, University of Barcelona, l'Hospitalet de Llobregat, Barcelona, Spain.,CIBER in Respiratory Diseases, Madrid, Spain
| | - Joan Minguell
- Orthopedic Surgery and Traumatology Department, Vall d´Hebron University Hospital, Barcelona, Spain.,School of Medicine and Health Science, Vall d´Hebron Campus, Autonomous University of Barcelona, Barcelona, Spain.,Reconstructive Surgery of the Locomotor System, Vall d´Hebron Research Institute, Barcelona, Spain
| | - Enrique Trilla
- School of Medicine and Health Science, Vall d´Hebron Campus, Autonomous University of Barcelona, Barcelona, Spain.,Urology Department, Vall d´Hebron University Hospital, Barcelona, Spain.,CIBBIM-Nanomedicine, Kidney Phisiopathology Research Group, Vall d´Hebron Research Institute, Barcelona, Spain
| | - Esperanza Zuriguel-Pérez
- Multidisciplinary Nursing Research Group, Vall d´Hebron Research Institute, Barcelona, Spain.,Management of Knowledge and Evaluation, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Cristina Martínez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Science, Bellvitge Campus, University of Barcelona, l'Hospitalet de Llobregat, Barcelona, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California
| |
Collapse
|
3
|
Abstract
Tobacco use will kill a projected 1 billion people in the 21st century in one of the deadliest pandemics in history. Tobacco use disorder is a disease with a natural history, pathophysiology, and effective treatment options. Anesthesiologists can play a unique role in fighting this pandemic, providing both immediate (reduction in perioperative risk) and long-term (reduction in tobacco-related diseases) benefits to their patients who are its victims. Receiving surgery is one of the most powerful stimuli to quit tobacco. Tobacco treatments that combine counseling and pharmacotherapy (e.g., nicotine replacement therapy) can further increase quit rates and reduce risk of morbidity such as pulmonary and wound-related complications. The perioperative setting provides a great opportunity to implement multimodal perianesthesia tobacco treatment, which combines multiple evidence-based tactics to implement the four core components of consistent ascertainment and documentation of tobacco use, advice to quit, access to pharmacotherapy, and referral to counseling resources.
Collapse
|
4
|
Besson A, Tarpin A, Flaudias V, Brousse G, Laporte C, Benson A, Navel V, Bouillon-Minois JB, Dutheil F. Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413328. [PMID: 34948936 PMCID: PMC8705497 DOI: 10.3390/ijerph182413328] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. METHODS PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. RESULTS Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. CONCLUSION Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.
Collapse
Affiliation(s)
- Anaïs Besson
- Family Medicine, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (A.B.); (A.T.)
| | - Alice Tarpin
- Family Medicine, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (A.B.); (A.T.)
| | - Valentin Flaudias
- Univ Angers, Laboratoire de psychologie des Pays de la Loire, Université de Nantes, LPPL, EA 4638, F-44000 Nantes, France;
| | - Georges Brousse
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont–Ferrand, France; (G.B.); (C.L.)
| | - Catherine Laporte
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, F-63000 Clermont–Ferrand, France; (G.B.); (C.L.)
| | - Amanda Benson
- Sport Innovation Research Group, Department of Health and Biostatistics, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
| | - Valentin Navel
- CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Jean-Baptiste Bouillon-Minois
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Emergency Medicine, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Correspondence: ; Tel.: +33-6-74-36-04-23; Fax: +33-4-73-27-46-49
| | - Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, F-63000 Clermont-Ferrand, France;
| |
Collapse
|
5
|
Inoue Y, Katoh T, Masuda S, Lu X, Koga T, Sadohara T, Sadanaga M, Tanaka E. Perioperative complications of abdominal surgery in smokers. J Anesth 2020; 34:712-718. [PMID: 32577911 PMCID: PMC7511283 DOI: 10.1007/s00540-020-02815-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
Purpose This study examined the association between smoking and perioperative complications of laparoscopic abdominal surgery and whether these complications were reduced with ≥ 4 weeks of preoperative smoking cessation. Methods A total of 555 patients who underwent gastric and colorectal cancer surgeries under general anesthesia were divided into the following groups retrospectively: 290 individuals without smoking history (NS group), 144 previous smokers (stopped smoking more than 8 weeks before surgery, PS group), and 121 current smokers (CS group) divided to two groups according to preoperative smoking cessation for < 4 (CS1, n = 76) and 4–8 weeks (CS2, n = 45). Results When compared with the NS group, postoperative hospitalization duration was significantly longer in the CS1 group (p < 0.01), whereas differences between the CS2 or PS groups and NS group were not significant. The total number of postoperative complications was higher in all groups of smoking than in NS group, independent on preoperative smoking cessation; however, suture failure was significantly more frequent only in CS1 group. Although pack-years did not significantly affect complication rates in smokers, duration of smoking cessation time in PS group was a negative predictor of postoperative complications. Conclusion Providing more than 4 weeks of smoking cessation before gastrointestinal surgery can reduce the duration of hospitalization and rate of suture failure.
Collapse
Affiliation(s)
- Yoshikazu Inoue
- Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8528, Japan. .,Department of Public Health, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjou, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Takahiko Katoh
- Department of Public Health, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjou, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Shota Masuda
- Department of Public Health, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjou, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Xi Lu
- Department of Public Health, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjou, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Tadashi Koga
- Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8528, Japan
| | - Tomohiro Sadohara
- Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8528, Japan
| | - Michiaki Sadanaga
- Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8528, Japan
| | - Eiji Tanaka
- Department of Surgery, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8528, Japan
| |
Collapse
|
6
|
Gräsbeck H, Ekroos H, Halonen K, Vasankari T. Weak smoking cessation awareness in primary health care before surgery: a real-world, retrospective cohort study. Scand J Prim Health Care 2020; 38:42-46. [PMID: 32019399 PMCID: PMC7054971 DOI: 10.1080/02813432.2020.1717093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: Tobacco smoking is a well-established risk factor for postoperative complications. Research on preoperative smoking cessation in primary health care is scarce.Design: This was a retrospective cohort study.Setting: The Stop Smoking before Surgery Project (SSSP) started in Porvoo, Finland, in May of 2016, involving both primary health care and specialized health care. The goals of the project were smoking awareness and preoperative smoking cessation.Subjects: Our study involved 1482 surgical patients operated at Porvoo Hospital between May and December of 2016.Main outcome measures: We studied the recording of smoking status in all patients, and ICD-10 diagnosis of nicotine dependency and the initiation of preoperative smoking cessation in current smokers. Variables were studied from electronic patient records, comparing primary health care referrals and surgical outpatient clinic records.Results: Smoking status was visible in 14.2% of primary health care referrals, and in 18.4% of outpatient clinic records. Corresponding rates for current smokers (n = 275) were 0.0 and 8.7% for ICD-10 diagnosis of nicotine dependence, and 2.2 and 15.3% for initiation of preoperative smoking cessation. The differences between primary health care referrals and outpatient clinic records were statistically significant for all three variables (p ≤ .001).Conclusion: In primary health care, very little attention was paid to preoperative smoking cessation. Rates were significantly better at the surgical outpatient clinic, but still low. We could not demonstrate any certain effect of the intervention. Our results call for future research on ways to improve smoking cessation rates.Key pointsTobacco smoking is a well-established risk factor for postoperative complications. Research on preoperative smoking cessation in primary health care is scarce.We found weak smoking awareness and weak smoking cessation intervention numbers among both primary and specialized health care doctors. Our results indicate an urgent need for an efficient preoperative smoking cessation model involving both primary and specialized health care.
Collapse
Affiliation(s)
- Helene Gräsbeck
- Department of Pulmonary Medicine, Porvoo Hospital, Porvoo, Finland;
- Doctoral Programme of Clinical Research, University of Helsinki, Helsinki, Finland;
- CONTACT Helene Gräsbeck Department of Pulmonary Medicine, Porvoo Hospital, Sairaalantie 1, 06150 Porvoo, Finland
| | - Heikki Ekroos
- Department of Pulmonary Medicine, Porvoo Hospital, Porvoo, Finland;
| | - Kimmo Halonen
- Department of Surgery, Porvoo Hospital, Porvoo, Finland;
| | - Tuula Vasankari
- Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland;
- Finnish Lung Health Association (FILHA), Helsinki, Finland
| |
Collapse
|
7
|
Roussel S, Frenay M. Links Between Perceptions and Practices in Patient Education: A Systematic Review. HEALTH EDUCATION & BEHAVIOR 2019; 46:1001-1011. [PMID: 31426684 DOI: 10.1177/1090198119868273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Two decades after "patient education" was defined by the World Health Organization, its integration in health care practices remains a challenge. Perceptions might shed light on these implementation difficulties. This systematic review aims to investigate links between perceptions and patient education practices among health care professionals, paying particular attention to the quality of practices in order to highlight any associated perception. Method. PubMed, PsycINFO, and Scopus were searched using the following search terms: "perceptions," "patient education," "health care professionals," and "professional practices." PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used. Results. Twenty studies were included. Overall findings supported the existence of links between some perceptions and practices. Links were either correlational or "causal" (generally in a single direction: perceptions affecting practices). Four types of perceptions (perceptions of the task including patient education, perceptions about the patient, perceptions of oneself as a health care professional, and perceptions of the context) were identified as being linked with educational practices. Links can although be mediated by other factors. Results concerning links should, however, be considered with caution as practices were mostly assessed by prevalence measurements, were self-reported and concerned exclusively individual education. When analyzing the quality of practices, the two retained studies highlighted their changing nature and the central role of perceptions with respect to the individual patient. Conclusions. This literature review led us to specify the quality criteria for further research: covering the entire spectrum of patient education, operationalizing variables, exploring specific practices, measuring the quality of practices, developing designs that facilitate causation findings, and considering a bidirectional perspective.
Collapse
Affiliation(s)
| | - Mariane Frenay
- Université catholique de Louvain, Louvain-la-neuve, Belgium
| |
Collapse
|
8
|
Smoking Cessation Care in Cardiothoracic Surgery: A Qualitative Study Exploring the Views of Australian Clinicians. Heart Lung Circ 2019; 28:1246-1252. [DOI: 10.1016/j.hlc.2018.04.293] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 04/02/2018] [Accepted: 04/18/2018] [Indexed: 12/26/2022]
|
9
|
Gavilán E, Moreno M, Pérez À, Castellano Y, Fernández E, Martínez C. Pre-surgical register of tobacco consumption. Med Clin (Barc) 2018; 151:315-319. [PMID: 29588061 DOI: 10.1016/j.medcli.2018.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/05/2018] [Accepted: 01/11/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVE Smoking cessation before surgery decreases the risk of complications. The aim of this study was to analyse the smoking register, associated variables and a short talk given to smokers in pre-surgical visits. MATERIAL AND METHOD Cross-sectional study. The pre-surgical records of 680 patients were assessed. We selected patient sociodemographic variables, surgical intervention characteristics, smoking status and consumption pattern. Logistic regression was used to study the variables association with smoking. RESULTS A percentage of 97.2 of the pre-surgical records include information on tobacco consumption. Overall 20% of surgical patients are smokers. The probability of smoking is higher among men (adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI] 1.7-4.0) and≤60 years (aOR 5.4, 95% CI 3.2-9.1). None of the records had information regarding a short talk given to patients to give up smoking. CONCLUSION Smoking consumption was prevalent, but the characterisation of a smoker's profile and short talk given to patient before surgery was practically nonexistent. Ensuring that patients who smokes receives a short talk to give up smoking before surgery is necessary.
Collapse
Affiliation(s)
- Eva Gavilán
- Hospital General Vall d'Hebron, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Unidad de Control de Tabaquismo, Programa de Prevención y Control del Cáncer, Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
| | - Montse Moreno
- Servicio de Prevención, Hospital Sant Joan de Déu de Martorell, Martorell, Barcelona, España
| | - Àngels Pérez
- Control de la Infección, Hospital Sant Joan de Déu de Martorell, Martorell, Barcelona, España
| | - Yolanda Castellano
- Unidad de Control de Tabaquismo, Programa de Prevención y Control del Cáncer, Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
| | - Esteve Fernández
- Unidad de Control de Tabaquismo, Programa de Prevención y Control del Cáncer, Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Grupo de Prevención y Control del Cáncer, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Departamento de Ciencias Clínicas, Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - Cristina Martínez
- Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Unidad de Control de Tabaquismo, Programa de Prevención y Control del Cáncer, Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Grupo de Prevención y Control del Cáncer, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Departamento de Salud Pública, Salud Mental y Perinatal, Facultad de Medicina y Ciencias de la Salud, Campus de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
| |
Collapse
|
10
|
Lee SM, Tenney R, Wallace AW, Arjomandi M. E-cigarettes versus nicotine patches for perioperative smoking cessation: a pilot randomized trial. PeerJ 2018; 6:e5609. [PMID: 30280019 PMCID: PMC6166615 DOI: 10.7717/peerj.5609] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/19/2018] [Indexed: 12/28/2022] Open
Abstract
Introduction Cigarette smoking by surgical patients is associated with increased complications. E-cigarettes have emerged as a potential smoking cessation tool. We sought to determine the feasibility and acceptability of e-cigarettes, compared to nicotine patch, for perioperative smoking cessation in veterans. Methods Preoperative patients were randomized to either the nicotine patch group (n = 10) or the e-cigarette group (n = 20). Both groups were given a free 6-week supply in a tapering dose. All patients received brief counseling, a brochure on perioperative smoking cessation, and referral to the California Smokers’ Helpline. The primary outcome was rate of smoking cessation on day of surgery confirmed by exhaled carbon monoxide. Secondary outcomes included smoking habits, pulmonary function, adverse events, and satisfaction with the products on day of surgery and at 8-weeks follow-up. Results Biochemically verified smoking cessation on day of surgery was similar in both groups. Change in forced expiratory volume in one second (FEV1) was 592 ml greater in the e-cigarette group (95% CI [153–1,031] ml, p = 0.01) and change in forced expiratory volume in one second to forced vital capacity ratio (FEV1/FVC ratio) was 40.1% greater in the e-cigarette group (95% CI [18.2%–78.4%], p = 0.04). Satisfaction with the product was similar in both groups. Discussion E-cigarettes are a feasible tool for perioperative smoking cessation in veterans with quit rates comparable to nicotine replacement patch. Spirometry appears to be improved 8-weeks after initiating e-cigarettes compared to nicotine patch, possibly due to worse baseline spirometry and more smoking reduction in the e-cigarette group. An adequately powered study is recommended to determine if these results can be duplicated.
Collapse
Affiliation(s)
- Susan M Lee
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, United States of America.,Anesthesia Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States of America.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Anesthesia, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Rachel Tenney
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, United States of America.,Anesthesia Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States of America
| | - Arthur W Wallace
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, United States of America.,Anesthesia Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States of America
| | - Mehrdad Arjomandi
- Medical Section, San Francisco VA Medical Center, San Francisco CA, United States of America.,Department of Medicine, University of California, San Francisco, CA, United States of America
| |
Collapse
|
11
|
Marinho IM, Carmona MJC, Benseñor FEM, Hertel JM, Moraes MFBD, Santos PCJL, Vane MF, Issa JS. Surgery is unlikely to be enough for a patient to stop smoking 24 h prior to hospital admission. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2018. [PMID: 29887037 PMCID: PMC9391712 DOI: 10.1016/j.bjane.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Introduction The need for surgery can be a decisive factor for long-term smoking cessation. On the other hand, situations that precipitate stress could precipitate smoking relapse. The authors decided to study the impact of a surgery on the patient's effort to cease smoking for, at least, 24 h before hospital admission and possible relapse on the last 24 h before hospital admission for ex-smokers. Methods Smoker, ex-smokers and non-smokers adults, either from pre-anesthetic clinic or recently hospital admitted for scheduled elective surgeries that were, at most, 6 h inside the hospital buildings were included in the study. The patients answered a questionnaire at the ward or at the entrance of the operating room (Admitted group) or at the beginning of the first pre-anesthetic consultation (Clinic group) and performed CO measurements. Results 241 patients were included, being 52 ex-smokers and 109 never smokers and 80 non-smokers. Smokers had higher levels of expired carbon monoxide than non-smokers and ex-smokers (9.97 ± 6.50 vs. 2.26 ± 1.65 vs. 2.98 ± 2.69; p = 0.02). Among the smokers, the Clinic group had CO levels not statistically different of those on the Admitted group (10.93 ± 7.5 vs. 8.65 ± 4.56; p = 0.21). The ex-smokers presented with no significant differences for the carbon monoxide levels between the Clinic and Admitted groups (2.9 ± 2.3 vs. 2.82 ± 2.15; p = 0.45). Conclusion A medical condition, such as a surgery, without proper assistance is unlikely to be enough for a patient to stop smoking for, at least, 24 h prior to admission. The proximity of a surgery was not associated with smoking relapse 24 h before the procedure.
Collapse
Affiliation(s)
- Igor Maia Marinho
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil
| | - Maria José C Carmona
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil.
| | | | - Julia Mintz Hertel
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil
| | | | | | - Matheus Fachini Vane
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil
| | - Jaqueline Scholz Issa
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil
| |
Collapse
|
12
|
Marinho IM, Carmona MJC, Benseñor FEM, Hertel JM, Moraes MFBD, Santos PCJL, Vane MF, Issa JS. [Surgery is unlikely to be enough for a patient to stop smoking 24h prior to hospital admission]. Rev Bras Anestesiol 2018; 68:344-350. [PMID: 29887037 DOI: 10.1016/j.bjan.2017.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 12/21/2017] [Accepted: 12/28/2017] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION The need for surgery can be a decisive factor for long-term smoking cessation. On the other hand, situations that precipitate stress could precipitate smoking relapse. The authors decided to study the impact of a surgery on the patient's effort to cease smoking for, at least, 24h before hospital admission and possible relapse on the last 24h before hospital admission for ex-smokers. METHODS Smoker, ex-smokers and non-smokers adults, either from pre-anesthetic clinic or recently hospital admitted for scheduled elective surgeries that were, at most, 6h inside the hospital buildings were included in the study. The patients answered a questionnaire at the ward or at the entrance of the operating room (Admitted group) or at the beginning of the first pre-anesthetic consultation (Clinic group) and performed CO measurements. RESULTS 241 patients were included, being 52 ex-smokers and 109 never smokers and 80 non-smokers. Smokers had higher levels of expired carbon monoxide than non-smokers and ex-smokers (9.97±6.50 vs. 2.26±1.65 vs. 2.98±2.69; p=0.02). Among the smokers, the Clinic group had CO levels not statistically different of those on the Admitted group (10.93±7.5 vs. 8.65±4.56; p=0.21). The ex-smokers presented with no significant differences for the carbon monoxide levels between the Clinic and Admitted groups (2.9±2.3 vs. 2.82±2.15; p=0.45). CONCLUSION A medical condition, such as a surgery, without proper assistance is unlikely to be enough for a patient to stop smoking for, at least, 24h prior to admission. The proximity of a surgery was not associated with smoking relapse 24h before the procedure.
Collapse
Affiliation(s)
- Igor Maia Marinho
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil
| | - Maria José C Carmona
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil.
| | | | - Julia Mintz Hertel
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil
| | | | | | - Matheus Fachini Vane
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil
| | - Jaqueline Scholz Issa
- Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil
| |
Collapse
|
13
|
Zaballos M, Canal MI, Martínez R, Membrillo MJ, Gonzalez FJ, Orozco HD, Sanz FJ, Lopez-Gil M. Preoperative smoking cessation counseling activities of anesthesiologists: a cross-sectional study. BMC Anesthesiol 2015; 15:60. [PMID: 25927569 PMCID: PMC4426771 DOI: 10.1186/s12871-015-0036-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 04/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smokers undergoing surgery are at a higher risk of complications than non-smokers. Preoperative evaluation by an anesthesiologist could provide an excellent opportunity to promote smoking cessation. Previous surveys of anesthesiologists have found that self-reported smoking cessation counseling rates have room for improvement, but no study has surveyed patients to obtain more accurate estimates. METHODS A single-center study was conducted from January 2010 to June 2010 in a tertiary teaching hospital. A telephone survey was conducted, which included all adult cigarette smokers who visited the preoperative anesthesia clinic. The survey recorded anesthesiologist-delivered interventions to help patients quit smoking before surgery. At the end of the study period, the self-reported smoking cessation counseling of the anesthesiologist was evaluated by questionnaire. RESULTS One thousand one hundred and sixty-five patients were evaluated, of which 217 were current smokers with a median pack-year of 15 (interquartile range 5.25-30.00) and 34% were scheduled to undergo major surgery. With regard to preoperative interventions, most anesthesiologists (85%) asked about smoking status, although only 31% advised patients about the health risks of smoking and 23% advised patients to quit before surgery. Provision of assistance to help patients quit was provided in 3% of cases. By contrast, 75% of anesthesiologists stated that they frequently or almost always advised patients about the health risks of smoking. CONCLUSIONS This study shows significant discrepancies between direct patient surveys of preoperative smoking cessation counseling activities by anesthesiologists and the self-reported perceptions of the anesthesiologists. Future studies are urgently needed to evaluate the provision of educational materials and other interventions to improve smoking cessation counseling rates among anesthesiologists and to narrow these discrepancies.
Collapse
Affiliation(s)
- Matilde Zaballos
- Department of Toxicology, Faculty of Medicine Complutense University, Madrid, Spain. .,Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
| | - Maria Iluminada Canal
- Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
| | - Rocío Martínez
- Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
| | - Maria José Membrillo
- Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
| | - Francisco J Gonzalez
- Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
| | - Hugo D Orozco
- Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
| | - Francisco J Sanz
- Department of Anaesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
| | - Maite Lopez-Gil
- Head of the Department of Anesthesiology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
| |
Collapse
|
14
|
Schultz CR, Benson JJ, Cook DA, Warner DO. Training for perioperative smoking cessation interventions: a national survey of anesthesiology program directors and residents. J Clin Anesth 2014; 26:563-9. [DOI: 10.1016/j.jclinane.2014.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 04/01/2014] [Accepted: 04/07/2014] [Indexed: 01/07/2023]
|
15
|
Peters SM, Pabelick CM, Warner DO. Tobacco control education in pediatric anesthesiology fellowships. Paediatr Anaesth 2013; 23:1213-8. [PMID: 24383603 DOI: 10.1111/pan.12277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cigarette smoking and secondhand smoke exposure (SHS) increase the risk of perioperative complications. Traditionally, anesthesiologists have limited involvement in tobacco control. OBJECTIVE To develop and disseminate an educational curriculum that educates pediatric anesthesia fellows in tobacco control. METHODS After IRB approval, an online survey was disseminated to pediatric anesthesiology fellowship directors. RESULTS Thirty-one surveys were completed. Most report that they ask pediatric patients about tobacco use. A majority advise their patients who smoke about the health effects of smoking, but only 40% advise children to quit, and the majority never provide educational materials to assist in smoking cessation. Half reported that they sometimes or always ask about SHS. Approximately one-third never advise about the ill effects of SHS, nearly half never advise parents to stop smoking, and the majority never provide educational material about quitting to parents. Two-thirds felt that it is their responsibility to advise pediatric patients not to smoke, but less than half felt the same sense of responsibility about advising parents not to smoke. Approximately two-thirds believe that fellowship programs should provide education about the effects of smoking in the perioperative period and the effects of SHS exposure, but few programs do. Almost all would implement a free teaching module about SHS exposure and tobacco control as part of fellowship education. CONCLUSIONS Many pediatric anesthesiology fellowship directors agree that exposure to cigarette smoke adversely impacts patients in the perioperative period, but few participate in tobacco control, and issues germane to tobacco control are not consistently addressed.
Collapse
|
16
|
Lee SM, Landry J, Jones PM, Buhrmann O, Morley-Forster P. The Effectiveness of a Perioperative Smoking Cessation Program. Anesth Analg 2013; 117:605-613. [DOI: 10.1213/ane.0b013e318298a6b0] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
17
|
Abstract
Background Although there has been a downward trend in smoking rates among medical doctors in recent years, rates have been higher among Japanese doctors when compared internationally. Methods We extensively reviewed all published English- and Japanese-language articles that reported the smoking rates of Japanese doctors. Results A total of 36 articles were examined, most of which had been conducted as postal surveys, usually by a national, prefectural, or local medical association. Sample sizes ranged from 17 to 11 773, and response rates ranged from 33% to 91%. National surveys conducted between 1965 and 2009 suggest that there has been a statistically significant (P < 0.0001) decline in smoking rates among Japanese doctors (from around 68% to 16% among males and from 19% to 5% among females). Conclusions Overall, the published data reveal a significant decline in smoking rates among Japanese doctors since 1965, especially among men. Although less than one-fifth of Japanese male doctors now smoke, more work needs to be done in tobacco control to help further reduce the burden of smoking, especially in medical schools.
Collapse
Affiliation(s)
- Derek R Smith
- School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, Australia.
| | | |
Collapse
|
18
|
Tønnesen H, Nielsen PR, Lauritzen JB, Møller AM. Smoking and alcohol intervention before surgery: evidence for best practice. Br J Anaesth 2009; 102:297-306. [PMID: 19218371 DOI: 10.1093/bja/aen401] [Citation(s) in RCA: 156] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Smoking and hazardous drinking are common and important risk factors for an increased rate of complications after surgery. The underlying pathophysiological mechanisms include organic dysfunctions that can recover with abstinence. Abstinence starting 3-8 weeks before surgery will significantly reduce the incidence of several serious postoperative complications, such as wound and cardiopulmonary complications and infections. However, this intervention must be intensive to obtain sufficient effect on surgical complications. All patients presenting for surgery should be questioned regarding smoking and hazardous drinking, and interventions appropriate for the surgical setting applied.
Collapse
Affiliation(s)
- H Tønnesen
- WHO Collaborating Centre for Evidence Based Health Promotion in Hospitals and Health Services, Copenhagen, Denmark.
| | | | | | | |
Collapse
|