title: Design and initial enrollment in the Vascular Physicians Offer and Report (VAPOR) trial.
abstract: Although patient smoking cessation is a key priority for vascular surgeons, significant variation exists in the manner in which vascular surgeons address this key process of care. We describe a multicenter, cluster-randomized trial that compares a standardized, brief smoking cessation intervention to usual care for patients facing vascular surgery or endovascular interventions. Eight centers were randomized to provide usual care for smoking cessation or a standardized protocol consisting of (1) physician "very brief advice" to stop smoking, (2) offering nicotine replacement therapy, and (3) referral to a phone-based counseling service. Trial enrollment began on September 1, 2014. At present, 142 patients had been enrolled in the trial across eight sites. Compared with patients in the usual care arm, patients enrolled in the smoking cessation intervention arm were more likely to receive physician advice (98% vs 77%), a prescription for nicotine replacement therapy (77% vs 13%), and quitline referral (93% vs 33%; all P < .001). Although final results of the intervention on smoking cessation rates are still forthcoming, surgeon delivery of a brief, evidence-based smoking cessation intervention appears feasible for patients facing invasive vascular care.
authors.affiliation: Section of Vascular Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Spangler
authors.affiliation: Section of Vascular Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Brooke
authors.affiliation: Section of Vascular Surgery, the University of Florida, Gainesville, Fla.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Beck
authors.affiliation: Division of Vascular Surgery, The Northwestern Memorial Hospital, Chicago, Ill.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hoel
authors.affiliation: Division of Vascular Surgery, Boston Medical Center, Boston, Mass.
authors.forename: Alik
authors.initials: A
authors.lastname: Farber
authors.affiliation: Section of Vascular Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH. Electronic address: philip.goodney@hitchcock.org.
authors.forename: Philip P
authors.initials: PP
authors.lastname: Goodney
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D003376:Counseling; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D018579:Patient Selection; D010865:Pilot Projects; D018570:Risk Assessment; D012307:Risk Factors; D018401:Sample Size; D012907:Smoking / Q000009:adverse effects / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013689:Telephone; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States; D014652:Vascular Diseases / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects