Implementing Smoking Cessation Programs Save

Rheumatologists are keen to the effects of smoking (increased arthritis risk, worse outcomes, blunted DMARD responses, added cardiopulmonary risks), but often do not have the resources or plan to encourage or implement smoking cessation from the rheumatology clinic.  A new study details the success of a rheumatology staff‐driven protocol, Quit Connect, to increase the rate of electronic referrals (e‐referrals) to free, state‐run tobacco quit lines (TQL).

Data was collected from three Wisconsin rheumatology clinics to compare baseline TQL referrals (in the 4 years prior to intervention) with TQL referrals in the six‐month intervention period. Nurses and medical assistants received training on how to use the electronic health record (EHR) to identify patients who they could: A) label as ready to quit smoking; B) advise cessation, or C) connect "ready" patients to state run smoking cessation programs. 

Descriptive statistics compared 54,090 pre‐ and post‐protocol rheumatology clinic visits; amongst who 4,601 were with current smokers.

Implementation of this protocol increased the odds of TQL referral 26‐fold (compared to pre‐implementation rate; unadjusted OR 26, CI 6‐106).

Even identifying those with readiness to quit in the next 30 days, increased over 100‐fold (adjusted OR 132, CI 99‐177).

Among those offered E‐referrals to state run TQL, 71.0% accepted quit line referrals and 54% of those ready to quit accepted referrals. Lastly, 24% of referred patients reported a quit attempt. 

Protocol driven processes that facilitate smoking cessation would be a welcome addition to patient wellness efforts eminating from rheumatology clinics.