The role of health professionals in informing patients with pulmonary diseases to stop smoking: final data of an Italian multicentric survey

Abstract

Introduction: Smoking increases the risk of developing different lung diseases. Quitting this habit at any point increase the effectiveness of the treatments and improve the prognosis of patients with any pulmonary disease. Few centers in Italy offer counseling to help cancer patients quit smoking. Methods: 490 patients with pulmonary diseases (344 lung cancer) were prospectively evaluated from January 2013 to February 2016. An anonymous survey was developed byWALCE (Women Against Lung Cancer in Europe) with the aim to understand if current/former smoker patients had received information by healthcare professionals about smoking cessation before or after diagnosis. The survey was conducted in several Italian Oncology and Pulmonology Divisions. Results: After a pulmonary disease diagnosis, 76% of patients declare to have stopped smoking, 17% to smoke less or not feel the same pleasure as before, 6% continue to smoke. Among 373 former smokers we collect information about timing of quit smoking in 225 cases: 42% stop at the time of diagnosis or even later, 37% 10 years before the diagnosis and 10% between 5-10 years earlier, while 11% less than 5 years before diagnosis. The majority of current smokers admit that they continue to smoke, because this helps them to relieve stress or simply they like it or smoking is an usual gesture for them. Patients not receiving information about smoking cessation by healthcare professionals were 38%, while 25% received it before diagnosis, 13% after it and 24% both before and after diagnosis. Concerning the reaction to counseling, 35% considers positively the health provider's action, even if 48% hoped to be more supported in quitting smoking. Only 19% of patients who attempted to quit smoking consider gradual termination as the most effective measure. Regarding the smoking-cessation methods or specific therapy adopted among former smokers: 83% disclosed they simply quitted smoking overnight, 5% used electronic cigarettes, 5% nicotine replacement, 4% books, 3% attended a dedicated clinic. Conclusions:We highlight that most patients stopped smoking after receiving their diagnosis. Although many of them have received advice by healthcare workers, the recourse to the use of specific techniques, drugs or access to dedicated clinic is very low. Many efforts need to be done to reduce that 38% of cases with pulmonary disease not receiving any indication about smoking cessation.