Telephone quitlines to help surgical patients quit smoking patient and provider attitudes

The scheduling of elective surgery provides an excellent opportunity for cigarette smoking-cessation interventions. Abstinence from smoking may improve immediate surgical outcomes, and the surgical period represents a teachable moment for modifying smoking behavior. However, a variety of barriers to intervention exist. This qualitative, formative research identified themes to guide the development of a brief intervention used by the providers of surgical services to promote the use of telephone quitlines.

Structured interviews were conducted in 2007 with 19 cigarette smokers either scheduled for or recently receiving surgery at Mayo Clinic, Rochester MN and ten providers of surgical services (anesthesiologists and surgeons).

Prominent patient themes included interest in quitting smoking around the time of surgery, a view of physicians having an important role in their cessation attempts, and a profound lack of knowledge regarding telephone quitline services. Patients were also poorly informed regarding the immediate benefits of quitting to surgical outcomes. Prominent provider themes included a similar ignorance of quitline services and a lack of time to deliver interventions. Although providers expressed interest in referring to quitlines if this could be easily accomplished, they were willing to spend only a limited amount of time learning how to intervene.

Both surgical patients and providers are potentially receptive to a quitline-based smoking-cessation intervention in the peri-operative period, but significant barriers exist.