A Smoking Cessation Strategy for Thoracic Surgeons

Tobacco use is the leading cause of preventable morbidity and mortality in the United States, and almost 90% of all lung cancers are caused by smoking tobacco. The dangers of smoking are well documented; the harms extend beyond lung cancer surgery and impact the efficacy and tolerability of other treatments such as chemotherapy. While studies have shown that physicians in various healthcare settings can be trained to successfully deliver effective smoking cessation interventions, thoracic surgeons receive little training in this area of care. There are only a few prospective reports of tobacco cessation efforts involving thoracic surgeons in the current literature. However, thoracic surgeons do have a distinct advantage over other healthcare providers because they have an opportunity to take advantage of the “teachable moment” and capitalize on cessation efforts when meeting with patients preoperatively and during recovery. Assessing a Brief Intervention In the March 2010 Annals of Thoracic Surgery, my colleagues and I published a prospective study to evaluate a brief tobacco cessation intervention offered by surgeons in an outpatient thoracic surgery clinic. The primary outcome was abstinence at 3 months. Adult smokers were enrolled in a single-arm pilot trial in which they received a 10-minute intervention that included three components. The first component involved a brief motivational interviewing session in which patients were asked about what they enjoyed and didn’t enjoy about smoking, what (if any) strategies they’ve used in the past to quit smoking, and how they’d like to quit smoking. Patients were also informed of the importance of quitting their habit. The second component was offering tobacco cessation medication for which a one-page handout that...