Engagement and Effectiveness of a Smoking Cessation Quitline Intervention in a Thoracic Surgery Clinic

Abstract

Importance: Smoking quitline programs effectively promote smoking cessation in outpatient primary care settings. Objective: To examine the factors associated with smoking quitline engagement and smoking cessation among patients undergoing thoracic surgery who consented to a quitline electronic referral. Design, Setting, and Participants: A retrospective cohort study was conducted from January 1, 2014, to December 31, 2018, among 111 active smoking patients referred to the quitline from a thoracic surgery outpatient clinic visit. Patients were divided into operative and nonoperative cohorts. Main Outcomes and Measures: Primary outcomes were engagement rates in the quitline program and successful smoking cessation. Secondary outcomes were self-reported point prevalence abstinence at 1 month and 6 months after the smoking quit date. Results: Of 111 patients (62 men; mean [SD] age, 61.8 [11.2] years) who had a quitline referral, 58 (52%) underwent surgery, and 32 of these 58 patients (55%) participated in the program. Of the 53 nonoperative patients (48%), 24 (45%) participated in the program. In the operative cohort, there was no difference in the smoking cessation rate between quitline participants and nonparticipants (21 of 32 [66%] vs 16 of 6 [62%]; P =.79) or in point prevalence abstinence at 1 month (23 of 32 [72%] vs 14 of 25 [56%]; P =.27) or 6 months (14 of 28 [50%] vs 6 of 18 [33%]; P =.36). Similarly, in the nonoperative cohort, there was no difference in the smoking cessation rate between quitline participants and nonparticipants (8 of 24 [33%] vs 11 of 29 [38%]; P =.78) or in point prevalence abstinence at 1 month (7 of 24 [29%] vs 8 of 27 [30%]; P =.99) or 6 months (6 of 23 [26%] vs 6 of 25 [24%]; P =.99). Regardless of quitline participation, operative patients had a 1.8-fold higher proportion of successful smoking cessation compared with nonoperative patients (37 of 58 [64%] vs 19 of 53 [36%]; P =.004) as well as a 2.2-fold higher proportion of 1-month point prevalence abstinence (37 of 57 [65%] vs 15 of 51 [29%]; P