title: A surgeon led smoking cessation intervention in a head and neck cancer centre.
abstract: BACKGROUND
  The government has recognised the role of healthcare professionals in smoking cessation interventions with integrated care pathways for identification and referral of at-risk patients who smoke. Referral for suspected cancers has been suggested as a 'teachable moment', whereby individuals are motivated and more likely to adopt risk-reducing behaviours. A head and neck cancer referral clinic could therefore provide opportunities for smoking cessation intervention. This study aims to pilot a brief smoking cessation intervention during a consultation visit for patients referred with suspected head and neck cancer and evaluate its acceptability and impact.
  
  
  METHODS
  A brief script for smoking cessation intervention which included a smoking cessation referral was designed to be delivered to patients attending a rapid access clinic. Patient outcome data was collected by the stop smoking team for patients who accepted the referral. A subset of these patients was also interviewed by telephone; these findings were combined with data provided by the stop smoking services to assess the acceptability and impact of pilot smoking cessation intervention on patients.
  
  
  RESULTS
  In total, 473 new patients attended the clinic during the study period, of whom 102 (22%) were smokers. Of these, 80 (78%) accepted a referral to stop smoking services. A total of 75 (74%) patients were approached subsequently in a telephone survey. Of the 80 newly referred patients, 29 (36%) quit smoking at least temporarily. Another eight patients reduced their smoking or set a quit date (10%), so the experience of attending the clinic and the intervention impacted favourably on almost half of the patients (46%). The patient survey found the intervention to be acceptable for 94% (n = 50) of patients. Qualitative analysis of patient responses revealed five elements which support the acceptability of the intervention.
  
  
  CONCLUSIONS
  The findings of this pilot study suggest that discussion of smoking cessation with patients referred for suspected head and neck cancer may have an impact and facilitate the process towards quitting. A possible diagnosis of cancer appears to present a 'teachable moment' to encourage positive health behaviour change.
authors.affiliation: Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, Denmark Hill Campus, London, SE5 9RS, UK. mingwei.tang@nhs.net.
authors.forename: Ming Wei
authors.initials: MW
authors.lastname: Tang
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK. Richard.Oakley@gstt.nhs.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Oakley
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK. Catherine.Dale@gstt.nhs.uk.
authors.forename: Catherine
authors.initials: C
authors.lastname: Dale
authors.affiliation: Guy's & St Thomas NHS Foundation Trust, Division of Cancer Studies, King's College London, London, UK. arniepurushotham@gmail.com.
authors.forename: Arnie
authors.initials: A
authors.lastname: Purushotham
authors.affiliation: King's College London, Cancer Epidemiology and Population Health, London, UK. henrik.moller@kcl.ac.uk.
authors.forename: Henrik
authors.initials: H
authors.lastname: Møller
authors.affiliation: Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, Denmark Hill Campus, London, SE5 9RS, UK. jenny.gallagher@kcl.ac.uk.
authors.forename: Jennifer Elizabeth
authors.initials: JE
authors.lastname: Gallagher
mesh_terms: D000328:Adult; D000368:Aged; D002173:Cancer Care Facilities; D005260:Female; D006258:Head and Neck Neoplasms; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D010865:Pilot Projects; D012017:Referral and Consultation; D040242:Risk Reduction Behavior; D016540:Smoking Cessation; D066231:Surgeons; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder