The Development and Implementation of a Multimodal Preoperative-specific Smoking Cessation Project

This project aimed to improve patient smoking abstinence preoperatively by increasing linkage to existing smoking cessation medication prescription and counseling referral interventions.

Pre and Post intervention quality improvement project.

We analyzed data from before (June 14, 2020 to December 14, 2020) and after (December 15, 2020 to June 15, 2021) the smoking cessation intervention using descriptive statistics, and t tests for continuous variables and χ² tests for categorical variables. The multimodal intervention included training preoperative clinicians and medical assistants, recruiting champions, tailored patient outreach letters, preoperative-specific scripts for smoking cessation education, and operational workflow.

There were significant pre-to-post-intervention increases in nicotine replacement therapy prescriptions (2% to 40%, P < .001) and Wellness Coach referrals (10% to 30%; P < .001); nicotine replacement therapy prescriptions filled among those with orders (0.7% to 17%) and completed Wellness Coach appointments among those with referrals (4% to 11%) also increased postintervention. Among the 116 patients who received a smoking cessation letter, 6% quit smoking before surgery. Clinicians (75%) and medical assistants (100%) were very satisfied (62.5% and 67%) or satisfied (12.5% and 33%) with the project.

A multimodal preoperative-specific smoking cessation project increases clinician uptakes of interventions and patient smoking abstinence preoperatively.