Unveiling the lessons from a virtual tobacco cessation program targeting surgical patients.

Abstract

Smoking cessation is associated with decreased morbidity and mortality as well as perioperative risk reduction. We aimed to explore video-based telehealth counseling as a potential avenue for smoking cessation. The purpose of this study was to determine rates of patient engagement in a video-based virtual point-of-care tobacco cessation program across varied general surgery clinics. This study implemented a workflow that engaged active smokers in surgery clinics with a video-based tobacco cessation program. The program included intake by a tobacco specialist nurse and longitudinal support by an advanced practice provider. Patient engagement and participation rates were evaluated across all steps in the cessation process. Three clinics implemented the tobacco cessation program over a 3-19-month period. Of the 702 patients who attended the clinic visit, 10.3% were referred to an advanced practice provider, and 5.4% attended at least 1 advanced practice provider visit. There were no significant differences in participation between races; however, White patients constituted sequentially higher proportions of patients in each progressive step. Upon further analysis, patients with hernias and gastrointestinal disease diagnoses were more likely to schedule and attend a smoking cessation session. Implementation of a virtual tobacco cessation program resulted in low engagement and behavior change. Although our goal was to leverage virtual care to provide resources not otherwise available in these general surgery clinics, the intervention may not have been aligned well with the patient population we were attempting to reach. Further studies are needed to understand the optimal engagement time, patient populations, and methods for the general surgery patient population.