Delivery and recording of smoking cessation advice in a Portuguese teaching hospital: the need for a systemic approach

Abstract

Background: Smoking cessation should be a top priority in hospitals. In November 2007, a Portuguese teaching hospital carried out a survey to evaluate cessation attitudes, clinical practices and cessation training needs among hospital-based healthcare providers (HCPs). The study also aimed to identify factors associated with cessation attitudes and practices, self-confidence to intervene and awareness of training programs.Method: This is a cross sectional questionnaire-based study including all HCPs.Sample: The study sample covers 424 HCPs, of which 65.4% were females. Mean age of these HCPs was 38.7 ± 10.1 years and the overall response rate was 50.5%. For data analyses, chi-squared tests, McNemar tests and multiple logistic regression models were used.Results: Most physicians and nurses reported “Asking” and “Advising” always or often. Other HCPs reported low frequencies of “Asking” and “Advising” (p < 0.001). Systematic “Asking” was reported less often than “Advising” (p < 0.001). Most HCPs did not record cessation practices, lacked specific training, and were not aware of their training needs. Reported self-confidence, positive attitudes and being a physician or non-smoker were the factors that influenced cessation practices the most.Conclusion: The findings suggest that there is reason to doubt that cessation practices are being undertaken effectively. Hospitals should audit smoking status recording, delivery of effective cessation advice and post-discharge support. Cessation indicators should be mandatory in all healthcare settings. To achieve these goals, undergraduate and graduate cessation training must be given higher priority.