Electronic opt-out smoking cessation proforma results in high levels of engagement among emergency surgical admissions

Abstract

<b>Introduction:</b> Smoking is associated with&nbsp;increased intra- and post-operative complications (A Turan et al. <i>Anaesthiology</i>. 2011;114(4)). While hospital-initiated smoking cessation programmes have significant impact on efforts to stop smoking (KA Mullen et al. <i>Tob Control</i> 2016;0:1-7), it is unclear&nbsp;if this applies to emergency surgical admissions. Within Liverpool University Hospitals Foundation Trust (LUHFT), a hospital with high rates of smoking-related admissions, the CURE team is a dedicated smoking cessation service. Identified smokers are automatically referred&nbsp;via an opt-out electronic system. We assessed smoking cessation efforts among emergency surgical admissions. <b>Methods:</b> Data were collected on admissions to LUHFT’s Emergency Surgical Admissions Unit (ESAU) from 1/1/21-31/3/21 inclusive. We assessed completion of smoking status proforma, nicotine replacement therapy (NRT) use, and CURE team involvement. <b>Results:</b> 661 patients were admitted to ESAU, with average admission of 7.4 days. Of 646 patients discharged alive, 341 (51.5%) had a smoking status proforma completed; of these, 29.9% (n=102) were smokers, 32% (n=109) ex-smokers, and 38.1% (n=130) never smokers. Smokers were automatically referred to the CURE team and a NRT prescription prompt generated. Of 102 smokers, 53.9% (n=55) were prescribed NRT, and 59.8% (n=74) offered smoking cessation support. 30 patients accepted ongoing support following assessment. <b>Conclusion:</b> Hospital admission provides a powerful trigger for cessation attempts in active smokers. Use of an&nbsp;e-proforma facilitating opt-out referral to a dedicated inpatient&nbsp;smoking cessation team&nbsp;shows high engagement among emergency surgical admissions.