Abstract
Background: Smoking is a significant risk factor for cancer. Over 90% of smokers consider quitting, but the majority does not use professional support, thus foregoing substantially higher chances of success (tenfold higher 1-year abstinence-rate). Hospitalized patients are especially receptive to cessation advice, but structured counseling of smoking in-patients is rarely available.
The aim of the project at the Comprehensive Cancer Center Freiburg (CCCF)/University Medical Center Freiburg (UMCF) is to establish a Cancer Prevention Management Team (CPMT) dedicated to identify smoking patients, motivate them to quit and link them to appropriate smoking cessation programs offered by external providers.
Methods: The CPMT was implemented as a structure to identify smoking patients to provide them with intensive counseling based on Motivational Interviewing, to enhance their motivation to quit and to refer them to suitable cessation programs. Enrolled patients (treatment arm) were referred to at least one form of cessation treatment (structured multicomponent program: individual/group setting, use of self-help materials, nicotine replacement therapy (NRT)) and received continued weekly telephone support by the CPMT. Enrolled patients who were unwilling to use any cessation therapy were followed up only (observation arm).
Results: CPMT structures and a screening system for smoking patients have been successfully implemented in 24 departments of the UMCF (1.113 hospital beds) organized in 60 wards and 10 outpatient departments. A network of 52 regional providers of evidence based cessation programs has been established. Within the first 15 months 703 smoking patients were counselled; 371 (52%) patients agreed to participate in the study. Out of these, 337 patients were included in the treatment arm, 34 patients were included in the observation arm of the program. The majority of the patients were suffering from patients (36%) or cardiovascular disease (19%).
Abstinence rates after 3 months (n=122) were 34.4% overall, counting patients with lost contact (n=24) as smokers. Among patients in the treatment arm, abstinence rates were higher in patients using behavioural therapy (BT) (44.0%) compared to patients not using BT (41.1%).
Conclusion: A Cancer Prevention Management Team is a highly efficient structure in large hospitals to screen patients for smoking status and motivate them to enter into a cessation program. Quit rates after 3 months were high, considering that all of these patients were treated in-hospital for severe illnesses and none of the patients had an initial intention to quit when entering the hospital.
Citation Information: Cancer Prev Res 2010;3(12 Suppl):B17.
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