PT  - JOURNAL ARTICLE
AU  - Joseph Sadek
AU  - Husein Moloo
AU  - Priscilla Belanger
AU  - Kara Nadeau
AU  - Debbie Aitken
AU  - Kris Foss
AU  - Terry Zwiep
AU  - Dan McIsaac
AU  - Lara Williams
AU  - Isabel Raiche
AU  - Reily Musselman
AU  - Kerri-Anne Mullen
TI  - Implementation of a systematic tobacco treatment protocol in a surgical outpatient setting: a feasibility study
AID  - 10.1503/cjs.009919
DP  - 2021 Feb 01
TA  - Canadian Journal of Surgery
PG  - E51--E58
VI  - 64
IP  - 1
4099  - http://canjsurg.ca/content/64/1/E51.short
4100  - http://canjsurg.ca/content/64/1/E51.full
SO  - CAN J SURG2021 Feb 01; 64
AB  - Background Smoking cessation programs started as late as 4 weeks before surgery reduce perioperative morbidity and death, yet outpatient clinic interventions are rarely provided. Our aim was to evaluate the feasibility of implementing a tobacco treatment protocol designed for an outpatient surgical setting.Methods We completed a pre–post feasibility study of the implementation of a systematic, evidence-based tobacco treatment protocol in an outpatient colorectal surgery clinic. Outcomes included smoking prevalence, pre- and postimplementation smoker identification and intervention rates, recruitment, retention, smoking cessation and provider satisfaction.Results Preimplementation, 15.5% of 116 surveyed patients were smokers. Fewer than 10% of surveyed patients reported being asked about smoking, and none were offered any cessation intervention. Over a 16-month postimplementation period, 1198 patients were seen on 2103 visits. Of these, 950 (79.3%) patients were asked smoking status on first visit and 1030 (86.0%) were asked on at least 1 visit. Of 169 identified smokers, 99 (58.6%) were referred to follow-up support using an opt-out approach. At 1-, 3- and 6-month follow- up, intention-to-quit rates among 78 enrolled patients were 24.4%, 22.9% and 19.2%, respectively. Postimplementation staff surveys reported that the protocol was easy to use, that staff would use it again and that it had positive patient responses.Conclusion Implementation of our smoking cessation protocol in an outpatient surgical clinic was found to be feasible and used minimal clinic resources. This protocol could lead to increases in identification and documentation of smoking status, delivery of smoking cessation interventions and rates of smoking reduction and cessation.