title: Structured smoking cessation training for health professionals on cardiology wards: a prospective study.
abstract: BACKGROUND
  Smoking is a major cardiovascular risk factor, and smoking cessation is imperative for patients hospitalized with a cardiovascular event. This study aimed to evaluate a systems-based approach to helping hospitalized smokers quit and to identify implementation barriers.
  
  
  METHODS
  Prospective intervention study followed by qualitative analysis of staff interviews.
  
  
  METHODS
  The prospective intervention study assessed the effects of implementing standard operating procedures (SOPs) for the provision of counselling and pharmacotherapy to smokers admitted to cardiology wards on counselling frequency. In addition, a qualitative analysis of staff interviews was undertaken to examine determinants of physician and nurse behaviour; this sought to understand barriers in terms of motivation, capability, and/or opportunity.
  
  
  RESULTS
  A total of 150 smoking patients were included in the study (75 before and 75 after SOP implementation). Before the implementation of SOPs, the proportion of patients reporting to have received cessation counselling from physicians and nurses was 6.7% and 1.3%, respectively. Following SOP implementation, these proportions increased to 38.7% (p < 0.001) and 2.7% (p = 0.56), respectively. Qualitative analysis revealed that lack of motivation, e.g. role incongruence, appeared to be a major barrier.
  
  
  CONCLUSIONS
  Introduction of a set of standard operating procedures for smoking cessation advice was effective with physicians but not nurses. Analysis of barriers to implementation highlighted lack of motivation rather than capability or opportunity as a major factor that would need to be addressed.
authors.affiliation: University Medical Centre Göttingen, Göttingen, Germany University College London, London, UK raupach@med.uni-goettingen.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Raupach
authors.affiliation: University Medical Centre Göttingen, Göttingen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Falk
authors.affiliation: University College London, London, UK.
authors.forename: Eleni
authors.initials: E
authors.lastname: Vangeli
authors.affiliation: University Medical Centre Göttingen, Göttingen, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schiekirka
authors.affiliation: Deutsches Netz Rauchfreier Krankenhäuser & Gesundheitseinrichtungen e.V., Berlin, Germany.
authors.forename: Christa
authors.initials: C
authors.lastname: Rustler
authors.affiliation: Sapienza University of Rome, Rome, Italy.
authors.forename: Maria Caterina
authors.initials: MC
authors.lastname: Grassi
authors.affiliation: University of Ottawa Heart Institute, Ottowa, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Pipe
authors.affiliation: University College London, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: West
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002309:Cardiology; D002318:Cardiovascular Diseases / Q000628:therapy*; D003376:Counseling; D005260:Female; D006282:Health Personnel; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010362:Patients' Rooms; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012307:Risk Factors; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data