Smoking cessation advice by rheumatologists: results of an international survey.
OBJECTIVE
The aim of this study was to understand practices regarding smoking cessation among rheumatologists for patients with inflammatory rheumatic diseases.


METHODS
A survey was sent to the rheumatologists participating in the multinational Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) group. The survey inquired about the clinical practice characteristics and practices regarding smoking cessation (proportion of smokers with inflammatory rheumatic diseases given smoking cessation advice, specific protocols and written advice material, availability of dedicated smoking cessation clinic).


RESULTS
Rheumatologists from 44 departments in 25 countries (16 European) completed the survey. The survey involved 395 rheumatologists, of whom 25 (6.3%) were smokers, and 199 nurses for patient education, of whom 44 (22.1%) were smokers. Eight departments (18.1 %) had a specific protocol for smoking cessation; 255 (64.5%) rheumatologists reported giving smoking cessation advice to all or almost all smokers with inflammatory diseases. In a regression model, early arthritis clinics (P = 0.01) and high gross domestic product countries (P = 0.001) were both independently associated with advice by the rheumatologist. Nurse gives advice to most patients in 11 of the 36 (30.5%) departments with nurses for patient education.


CONCLUSIONS
Advice for smoking cessation within rheumatology departments is not homogeneous. In half of the departments, most doctors give advice to quit smoking to all or almost all patients with inflammatory diseases. However, only one in five departments have a specific protocol for smoking cessation. Our data highlight the need to improve awareness of the importance of and better practice implementation of smoking cessation advice for inflammatory rheumatic disease patients.
Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrin, University of Las Palmas, Las Palmas, Spain, Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Department of Internal Medicine, University of Genova, Genova, Italy, Department of Rheumatology, Chonnam National University Hospital, Gwanju, Republic of Korea, Rheumatology Clinic, Riverside Professional Centre, Sydney, NS, Canada, Rheumatology Centre, East-Tallinn Central Hospital, Tallinn, Estonia, Rheumatic Disease Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India and Department of Rheumatology, Jyväskyä Central Hospital, Jyväskyä, Finland. anarher@gobiernodecanarias.org.
Antonio
A
Naranjo
Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrin, University of Las Palmas, Las Palmas, Spain, Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Department of Internal Medicine, University of Genova, Genova, Italy, Department of Rheumatology, Chonnam National University Hospital, Gwanju, Republic of Korea, Rheumatology Clinic, Riverside Professional Centre, Sydney, NS, Canada, Rheumatology Centre, East-Tallinn Central Hospital, Tallinn, Estonia, Rheumatic Disease Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India and Department of Rheumatology, Jyväskyä Central Hospital, Jyväskyä, Finland.
Nasim A
NA
Khan
Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrin, University of Las Palmas, Las Palmas, Spain, Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Department of Internal Medicine, University of Genova, Genova, Italy, Department of Rheumatology, Chonnam National University Hospital, Gwanju, Republic of Korea, Rheumatology Clinic, Riverside Professional Centre, Sydney, NS, Canada, Rheumatology Centre, East-Tallinn Central Hospital, Tallinn, Estonia, Rheumatic Disease Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India and Department of Rheumatology, Jyväskyä Central Hospital, Jyväskyä, Finland.
Maurizio
M
Cutolo
Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrin, University of Las Palmas, Las Palmas, Spain, Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Department of Internal Medicine, University of Genova, Genova, Italy, Department of Rheumatology, Chonnam National University Hospital, Gwanju, Republic of Korea, Rheumatology Clinic, Riverside Professional Centre, Sydney, NS, Canada, Rheumatology Centre, East-Tallinn Central Hospital, Tallinn, Estonia, Rheumatic Disease Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India and Department of Rheumatology, Jyväskyä Central Hospital, Jyväskyä, Finland.
Shin-Seok
SS
Lee
Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrin, University of Las Palmas, Las Palmas, Spain, Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Department of Internal Medicine, University of Genova, Genova, Italy, Department of Rheumatology, Chonnam National University Hospital, Gwanju, Republic of Korea, Rheumatology Clinic, Riverside Professional Centre, Sydney, NS, Canada, Rheumatology Centre, East-Tallinn Central Hospital, Tallinn, Estonia, Rheumatic Disease Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India and Department of Rheumatology, Jyväskyä Central Hospital, Jyväskyä, Finland.
Juris
J
Lazovskis
Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrin, University of Las Palmas, Las Palmas, Spain, Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Department of Internal Medicine, University of Genova, Genova, Italy, Department of Rheumatology, Chonnam National University Hospital, Gwanju, Republic of Korea, Rheumatology Clinic, Riverside Professional Centre, Sydney, NS, Canada, Rheumatology Centre, East-Tallinn Central Hospital, Tallinn, Estonia, Rheumatic Disease Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India and Department of Rheumatology, Jyväskyä Central Hospital, Jyväskyä, Finland.
Karin
K
Laas
Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrin, University of Las Palmas, Las Palmas, Spain, Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Department of Internal Medicine, University of Genova, Genova, Italy, Department of Rheumatology, Chonnam National University Hospital, Gwanju, Republic of Korea, Rheumatology Clinic, Riverside Professional Centre, Sydney, NS, Canada, Rheumatology Centre, East-Tallinn Central Hospital, Tallinn, Estonia, Rheumatic Disease Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India and Department of Rheumatology, Jyväskyä Central Hospital, Jyväskyä, Finland.
Sapan
S
Pandya
Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrin, University of Las Palmas, Las Palmas, Spain, Department of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Department of Internal Medicine, University of Genova, Genova, Italy, Department of Rheumatology, Chonnam National University Hospital, Gwanju, Republic of Korea, Rheumatology Clinic, Riverside Professional Centre, Sydney, NS, Canada, Rheumatology Centre, East-Tallinn Central Hospital, Tallinn, Estonia, Rheumatic Disease Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India and Department of Rheumatology, Jyväskyä Central Hospital, Jyväskyä, Finland.
Tuulikki
T
Sokka
D019538:Health Care Surveys; D006801:Humans; D010820:Physicians; D010818:Practice Patterns, Physicians'; D012219:Rheumatology; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires
medical advice; rheumatoid arthritis; tobacco smoking