title: Clinician-delivered intervention to facilitate tobacco quitline use by surgical patients.
abstract: BACKGROUND
  Telephone quitlines that provide counseling support are efficacious in helping cigarette smokers quit and have been widely disseminated; currently, they are underused. Surgery represents a teachable moment for smoking cessation, which can benefit surgical outcomes; however, few surgical patients receive smoking cessation interventions. This study developed and tested a clinician-delivered intervention to facilitate quitline use by adult patients scheduled for elective surgery.
  
  
  METHODS
  After formative work involving patients and clinicians, a brief intervention was designed to facilitate telephone quitline use. It was then evaluated in a randomized trial of 300 adults scheduled for elective surgery. A control standard brief stop-smoking intervention served as a comparator, with both interventions delivered by clinicians. The primary outcome was the use rate of a quitline accessed through a dedicated toll-free telephone number, with use defined as completing at least one full counseling session. Secondary outcomes included self-reported abstinence from cigarettes at 30 and 90 days postoperatively.
  
  
  RESULTS
  Subject characteristics were similar between the two groups. Records from the designated quitline documented that 29 of 149 subjects (19.5%) in the quitline intervention group and 0 of 151 subjects in the control group completed the first full counseling session (P < 0.0001). There were no significant differences in the self-reported point-prevalent and continuous abstinence rates between groups at either 30 or 90 days postoperatively, although rates tended to be higher in the quitline intervention group.
  
  
  CONCLUSIONS
  Clinicians can effectively facilitate quitline use by surgical patients. Further work is necessary to evaluate the efficacy of this approach in terms of long-term abstinence from cigarette smoking.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA. warner.david@mayo.edu
authors.forename: David O
authors.initials: DO
authors.lastname: Warner
authors.forename: Robert C
authors.initials: RC
authors.lastname: Klesges
authors.forename: Lowell C
authors.initials: LC
authors.lastname: Dale
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Offord
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: Yu
authors.initials: Y
authors.lastname: Shi
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Vickers
authors.forename: David R
authors.initials: DR
authors.lastname: Danielson
mesh_terms: D000328:Adult; D017558:Elective Surgical Procedures; D005260:Female; D015277:Hotlines / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011300:Preoperative Care; D016730:Program Development; D015397:Program Evaluation; D016540:Smoking Cessation / Q000379:methods*