Education, Teaching, and Quality Improvement |

Inpatient Smoking Cessation Counseling and Treatment for Patients With Lung Cancer FREE TO VIEW

Shireen Mirza; Bruno Bockorny; Roy Sittig; Lori Bastian, MPH
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University of Connecticut, Farmington, CT

Chest. 2014;146(4_MeetingAbstracts):527A. doi:10.1378/chest.1995000
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SESSION TITLE: Quality & Clinical Improvement Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Patients who continue to smoke after a diagnosis of lung cancer experience increased morbidity and mortality. A hospital admission after the diagnosis of lung cancer provides an opportunity to counsel the patient to quit smoking and to provide treatment for smoking cessation but many providers may believe that treating tobacco dependence is futile in this population. The purpose of this study was to investigate whether patients who continue to smoke after a diagnosis of lung cancer are offered smoking cessation services during their hospitalization.

METHODS: Utilizing a registry of lung cancer diagnoses, we conducted retrospective chart reviews of patients with lung cancer admitted to a teaching hospital after their diagnosis (2008-2014). We assessed clinical stage and smoking status. The primary outcome measure was receipt of smoking cessation counseling and/or treatment while hospitalized.

RESULTS: Overall, 119 women and 99 men diagnosed with lung cancer were included in this study (n=218). With regard to demographic information, patients with lung cancer had an average age at diagnosis of 68.5 years (SD 13.6) and were mostly White (89.9%). Overall, 12.4% had small cell histology and 42.2% had advanced clinical stage (IV). More than a quarter of patients (26.6%) were current smokers. Among current smokers, 47% were provided smoking cessation counseling utilizing a nurse protocol but only 10% were offered smoking cessation treatments such as nicotine patches. There was no evidence that smoking cessation counseling or treatment counseling was associated with presence or absence of advanced stage of disease (p=0.76).

CONCLUSIONS: Results of this study highlight the need to improve barriers to smoking cessation treatment for hospitalized patients with lung cancer. Standard nursing protocols result in higher rates of smoking cessation counseling. Providers may require standard orders to reduce barriers to providing smoking cessation treatments. Future research needs to explore if smoking cessation can improve short-term outcomes among hospitalized patients with lung cancer.

CLINICAL IMPLICATIONS: Raising awareness and implementing protocols may be key to improving smoking cessation counseling and treatment in patients with lung cancer in order to decrease morbidity and mortality.

DISCLOSURE: The following authors have nothing to disclose: Shireen Mirza, Bruno Bockorny, Roy Sittig, Lori Bastian

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