Implementing a Staff-Led Smoking Cessation Intervention in a Diverse Safety-Net Rheumatology Clinic: A Pre-Post...

Area of Science:

• Public Health
• Clinical Interventions
• Health Disparities

Background:

• Smoking cessation interventions are crucial for improving patient outcomes.
• The Quit Connect (QC) intervention previously demonstrated success in a White academic health care setting.
• Adaptation of QC for a safety-net rheumatology clinic serving a predominantly Black population was needed.

Purpose of the Study:

• To test the feasibility and impact of the Quit Connect (QC) intervention in a safety-net rheumatology clinic.
• To evaluate QC's effectiveness in improving tobacco screening, readiness-to-quit assessment, and referrals among patients who smoke.
• To assess the cost-effectiveness and acceptability of QC in this specific patient population.

Main Methods:

• A pre-post study design was employed, analyzing adult rheumatology visits over 18 months post-intervention and 12 months pre-intervention.
• Electronic health record (EHR) data were used to compare process and clinical outcomes, including offers, referrals, and documented cessation.
• Clinic staff participated in focus groups and questionnaires to assess intervention feasibility and acceptability; cost-effectiveness was also evaluated.

Main Results:

• The study population (n=550) was 89.8% Black and 69.5% women.
• Following QC implementation, the assessment of quit readiness increased from 8.1% to 31.8% of visits with patients who smoke.
• Of patients accepting cessation services, 37% reached set a quit date, with intervention costs ranging from $4 to $10 per quit attempt.

Conclusions:

• The Quit Connect (QC) intervention is feasible and acceptable in a safety-net rheumatology clinic with a predominantly Black patient population.
• QC significantly improved tobacco screening, readiness-to-quit assessment, and referrals for smoking cessation.
• The intervention proved to be a cost-effective strategy for promoting smoking cessation in this underserved population.