Surmounting Obstacles to Smoking Prevention: Barriers to Smoking Cessation Counseling at a Community-based Health Center in Connecticut

Background: Cigarette smoking is currently a leading cause of morbidity and mortality in the United States and throughout the world. Smoking cessation has emerged as an important preventative avenue for reducing the population-level attributable risk of cardiovascular, pulmonary, and oncologic disease due to cigarette smoking. Despite the health benefits of abstinence, durable smoking cessation is achieved by only a fraction of current smokers. As potential agents of change, healthcare providers possess the ability to promote smoking cessation through both counseling and pharmacotherapy. Consequently, the purpose of this investigation was to assess the challenges and limitations encountered by the Smoking Cessation Counseling Service at Optimus Health Care, the largest community-based health center in a low income area of Connecticut. Methods: Following a literature review of current best practices for smoking cessation in the clinical setting, this study utilized an interview and survey tool to identify the primary barriers to smoking cessation counseling in partnership with the healthcare providers at Optimus Health Care. Results: Preliminary demographic data indicated that approximately 88% of the smoking patients at Optimus Health Care have received smoking cessation counseling in the last 12 months. The main barriers assessed in this study included time with patients, patient motivation, access to cessation interventions, and patient comorbidities. Through a series of 14 healthcare provider interviews and 13 survey questionnaires throughout the locations of Optimus Health Care, this study illuminated the lack of time in clinician schedule, patient’s preparedness to quit, and competing patient comorbidities as the primary barriers to providing smoking cessation counseling. Conclusions: Understanding the barriers to smoking cessation counseling faced by healthcare providers in the community setting remains an important objective for disease prevention and public health. This study identified the main barriers cited by clinicians in the community setting towards providing smoking cessation and generates recommendations for community-based healthcare providers regarding surmounting barriers to smoking cessation counseling.https://elischolar.library.yale.edu/ysph_pbchrr/1039/thumbnail.jp