Implementation of Smoking Cessation Intervention in General Surgery Clinics

Area of Science:

• Surgical Oncology
• Public Health
• Behavioral Science

Background:

• Smoking significantly increases the risk of postoperative complications.
• Effective preoperative smoking cessation interventions are crucial for improving surgical outcomes.
• Understanding implementation challenges in clinical settings is vital for program success.

Purpose of the Study:

• To evaluate the implementation of a virtual tobacco cessation program in general surgery clinics.
• To identify barriers and facilitators from provider and staff perspectives.
• To assess patient engagement with the implemented program.

Main Methods:

• A tobacco treatment registered nurse (TTRN) developed and implemented a cessation workflow.
• The program involved initial RN intake and referral to Advanced Practice Providers.
• Patient engagement was evaluated, alongside qualitative data from staff focus groups and provider interviews.

Main Results:

• The virtual program was implemented across 3 clinics over 3-19 months.
• Higher patient engagement occurred when the TTRN was physically present or made post-visit calls.
• Key barriers included patient resistance and workflow integration issues, while TTRN availability was an asset.

Conclusions:

• Virtual TTRN implementation in surgery clinics resulted in low patient engagement.
• Workflow integration and limited patient acceptance made the program unsustainable.
• Further research is needed to determine optimal methods and timing for preoperative smoking cessation engagement.