Author of

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  P2.10 - Prevention and Tobacco Control (Not CME Accredited Session) (ID 959)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 27098

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    P2.10-05 - Provider Medical Specialty Influences Smoking Cessation Counseling at an Academic Medical Center and Veterans Affairs in U.S. Mid-South (ID 12820)

    16:45 - 18:00  |  Author(s): Hilary A Tindle
    • Abstract
    • Slides

    Background
    

    Tobacco accounts for 11.5% of deaths worldwide and approximately 30% of U.S. cancer deaths. Smoking cessation counseling using the 5 A’s (Ask, Advise, Assess, Assist, Arrange) is standard-of-care for all smokers. We tested the hypothesis that certain provider characteristics (general internal medicine [GIM], those with lung cancer screening [LCS] knowledge, and those who perceive smoking cessation as very effective) would be associated with smoking cessation counseling.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We surveyed all GIM, pulmonology, hematology/oncology, and gynecology providers (physicians/advanced practice providers) at a large academic institution in the Mid-South and affiliated VA from February to May 2017. The primary predictor variables were provider characteristics including: specialty, LCS guideline knowledge (high knowledge=identified start age 55, 30 pack-years, current & former smokers), and perceived effectiveness of smoking cessation, colonoscopy, and pap smear at reducing cancer mortality (very/moderately/minimally/not effective). The primary outcome was self-reported smoking cessation counseling using the 5 A’s within the past year. Data were summarized using counts, proportions, and medians. We used multivariable logistic regression adjusted for years in practice and healthcare system to evaluate the association of medical specialty with counseling. Logistic regressions of perceived effectiveness and LCS guideline knowledge as predictors of counseling were further adjusted for specialty.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Of 625 providers invited, 407 (65%) responded, 378 (60.5%) questionnaires were analyzed, of which 58% were GIM, 19% hematology/oncology, 13% gynecology, 10% pulmonology. There were 255 of 350 providers (73%) who reported performing smoking cessation counseling within the past year (77% GIM vs 77% pulmonology vs 57% hematology/oncology vs 72% gynecology, χ² p=0.013). In adjusted multivariable logistic regression, GIM (aOR 2.52 95% CI 1.40,4.54;p=0.002) and pulmonology (aOR 2.52 95% CI 1.00,6.36;p=0.05) providers were more likely to perform smoking cessation counseling than hematology/oncology providers.

    41% vs 59% of those who provided counseling had high LCS knowledge vs low LCS knowledge. Fewer providers (71%) reported smoking cessation as very effective at reducing cancer-specific mortality compared to colonoscopy (77%) and pap-smear (74%). Perceived effectiveness and high LCS guideline knowledge did not predict smoking cessation counseling (aOR 1.1 95% CI 0.64,1.8;p=0.78;aOR 1.2 95% CI 0.72,2.0 p=0.47 respectively).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Providers in general internal medicine and pulmonology were more likely than those in hematology/oncology to report performing smoking cessation counseling. Perceived effectiveness and LCS guideline knowledge did not predict smoking cessation counseling. Targeted interventions, especially in hematology/oncology, are needed to increase smoking cessation counseling using the 5 A’s. Future education should also address knowledge gaps in smoking cessation effectiveness and LCS guidelines.

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