Decision Aid for Cigarette Smokers Scheduled for Elective Surgery

Area of Science:

• Health communication
• Decision science
• Surgical patient care

Background:

• Decision aids enhance patient engagement in healthcare choices.
• A decision aid was created to support discussions on smoking behavior modification around elective surgery.

Purpose of the Study:

• To develop and pilot-test a decision aid for clinician-patient discussions on smoking cessation options before and after surgery.
• To evaluate if the decision aid improves decisional quality compared to usual care.

Main Methods:

• Formative work involved designing a decision aid with three smoking behavior options: continue, temporary abstinence, or permanent cessation.
• A randomized pilot study compared the decision aid to usual care in 130 surgical patients.

Main Results:

• The decision aid, comprising three laminated cards with pros/cons and graphics, significantly improved decisional quality and patient involvement (p < 0.05).
• Effect sizes for improved decisional quality and patient involvement were substantial (Cohen's d = 0.76 and 1.20).
• No significant impact was observed on perioperative smoking behavior or adherence to chosen cessation strategies.

Conclusions:

• Decision aids can substantially enhance decisional quality and patient involvement in discussions about perioperative smoking.
• The decision aid, as implemented, did not independently alter perioperative smoking behavior.