Smoking cessation counseling in vascular surgical practice using the results of interviews and focus groups in the Vascular Surgeon offer and report smoking cessation pilot trial

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• 作者：Karina Newhall ; MD^a ; ^{karina.a.newhall@hitchcock.org" class="auth_mail" title="E-mail the corresponding author} ; Mary Burnette ; MD^b ; Benjamin S. Brooke ; MD ; PhD^c ; Andres Schanzer ; MD^d ; TzeWoei Tan ; MD^e ; Susan Flocke ; MD^f ; Alik Farber ; MD^g ; Philip Goodney ; MD^h ; on behalf of the VAPOR InvestigatorsAndrew W. Hoel ; MD ; Adam Beck ; MD ; Benjamin S. Brooke ; MD ; PhD ; John Jeb Hallet ; MD ; Andres Schanzer ; MD ; TzeWoei Tan ; MD ; Alik Farber ; MD ; Nancy Birkmeyer ; PhD ; Mary Burnette ; MD ; Nancy Rigotti ; MD ; Susan Flocke ; MD ; Maria Orlando Edelen ; PhD ; Alistair J. O'Malley ; PhD ; Dan Neal ; MS ; Sandi Siami ; MPH ; Colleen Kollman ; MBA ; Emily Spangler ; MD ; Philip Goodney ; MD
• 刊名：Journal of Vascular Surgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：63
• 期：4
• 页码：1011-1017.e2
• 全文大小：645 K

文摘

Although smoking cessation is a key priority emphasized by professional societies and multidisciplinary consensus guidelines, significant variation exists in the methods and efficacy of smoking cessation treatment practiced by vascular surgeons. We conducted a series of patient, surgeon, and nonpatient stakeholder focus groups to identify important domains for establishment of a successful smoking cessation program.

Methods

As part of a planning effort for a randomized clinical trial on usual care vs a standardized, evidence-based smoking cessation intervention, our group performed a series of interviews and focus groups. These were four 1-hour interviews, conducted with stakeholders such as tobacco cessation counselors (n = 2), a Quit Line representative (n = 1), and a Vascular Quality Initiative leader (n = 1), as well as two 90-minute, formal, professionally moderated focus groups, one with vascular surgeons (n = 7), and another with patients (n = 4). Transcripts and audio recordings were qualitatively reviewed for themes to establish the most important domains perceived to be associated with a successful smoking cessation program.

Results

Patients emphasized four domains critical for a successful smoking cessation program: the motivation to quit, an individualized approach, the timing of an intervention, and the tone of the physician who offers counseling. Although surgeons and nonpatient stakeholders also emphasized the importance of a compassionate physician tone, surgeons and nonpatient stakeholders differed from patients in their remaining domains. They emphasized the feasibility of a brief intervention in a busy clinical practice, implementation of the effort, and necessary infrastructure for smoking cessation programs. All focus group participants described a brief, evidence-based smoking cessation intervention as feasible in routine vascular practice.

Conclusions

Differences in motivation and significance exist for patients, surgeons, and stakeholders when they considered the specific domains most important in building a successful smoking cessation program. Despite these differences, all parties involved agreed that a brief, standardized intervention can be successful delivered in a busy vascular clinic setting.