The Vancouver General Hospital Smoking Cessation Clinic: Outcomes from a Specialist Cessation Service within Cardiology

PURPOSE: The purpose of our study is to examine pilot treatment outcomes of an outpatient Smoking Cessation Clinic (SCC) provided within Cardiology Services. RELEVANCE/CONTEXT: Populations with cardiac conditions often continue to smoke at high rates (up to 62%), even after experiencing life-threatening cardiac events. Smoking cessation can greatly reduce the risk of further occurrence of a cardiac event and associated mortality. However few Cardiology services in Canada offer smoking cessation services and few Cardiologists refer smoking patients to such services. The Vancouver General Hospital’s SCC is housed within Cardiology Services and offers a longitudinal approach to smoking cessation. This treatment approach is in recognition of tobacco dependence as a chronic, relapsing medical condition whereby smoking cessation is considered “a process and not an event.” The clinic now runs 3 full days a week and is staffed by a team of specialists in tobacco dependence treatment comprising of two nurses and a physician. METHODS/ANALYSIS: This study is based on a retrospective review of the charts of 117 participants of the SCC (between Sept 2010 and May 2012). The primary components of intervention include tailored pharmacotherapy and behavioural counselling. The main outcome of interest is self-reported 7-day point-prevalence of smoking abstinence verified by expired CO level (when available). RESULTS/SIGNIFICANCE: 35% of participants achieved smoking cessation, whereas 42.1% of those who did not achieve cessation were able to reduce their cigarette use to 50% (or less) of their baseline consumption. In multivariate logistic regression analysis, salient predictors of smoking cessation included being male (OR= 3.2, 95% CI = 1.0-10.0) and a greater length of time (in weeks) in the programme (OR= 1.0, 95% CI = 1.0-1.1). The modest outcomes from this pilot study support the need for smoking cessation treatment provision in hospital Cardiology settings. Such interventions reduce the disproportionate burden of tobacco use and related disease among populations with medical co-morbidity