The role of health care professionals in smoking cessation among patients with pulmonary diseases: an Italian multicentric survey

Abstract

Background: Smoking causes many lung diseases, quitting this habit at any time provides positive results and gives the best chance for treatment all patients with pulmonary diseases, including lung cancer patients. Only few Italian centers offer counseling for smoking cessation in cancer patients. Method: 408 patients with pulmonary diseases (293 with lung cancer) were evaluated from January 2013 to February 2015. An anonymous survey was developed with the aim to understand if current or former smoker patients had received information by health care professionals about smoking cessation before or after diagnosis. The survey was conducted in several Italian Thoracic Oncology Units and Pulmonology Divisions. Results: After a pulmonary disease diagnosis, 72% of patients state to quit smoking, 20% to smoke less or not feel the same pleasure as before, 8% confirms to continue to smoke. Among 298 former smokers, 150 patients state how long they quitted smoking and 45% at the time of diagnosis or even later, about 35% 10 years before the diagnosis and 8% between 5 and 10 years earlier, while 12% more recently. Most of current smokers state continue to smoke because it helps them to control the stress or because they like it or because smoking is a repetitive gesture. Data show that 39% of patients did not receive information about smoking cessation by health professionals, 26% received it before the diagnosis, 12% after it and 23% received it both before and after diagnosis. Concerning the reaction to counseling, 53% considers positively the health care provider action, even if 28% hoped they could have helped them more quit smoking and 19% reports a warning and paternalistic attitude of them and also embarrassment. Only 23% of patients who attempted to quit smoking consider the gradual termination as the most effective measure. Regarding the smoking-cessation method or specific therapy adopted: 65% disclosed they simply quitted smoking overnight and 80% confirmed this as the most effective technique; 16% used electronic cigarettes, 8% a nicotine replacement treatment, 7% books and 4% attending a dedicated clinic. Conclusion: The analysis of the results underlines that most patients quitted smoking after having received their diagnosis. Although many of them received advice by healthcare workers, the recourse to the use of techniques, drugs or access to specific clinic is still very low, especially considering that 50% of patients result highly dependent to nicotine.