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    Feasibility and pilot efficacy of a brief smoking cessation intervention delivered by vascular surgeons in the Vascular Physician Offer and Report (VAPOR) Trial

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    Authors
    Goodney, Philip
    Spangler, Emily L.
    Newhall, Karina
    Brooke, Benjamin S.
    Schanzer, Andres
    Tan, Tze-Woei
    Beck, Adam W.
    Hallett, John W.
    MacKenzie, Todd A.
    Edelen, Maria Orlando.
    Hoel, Andrew W.
    Rigotti, Nancy A.
    Farber, Alik
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    UMass Chan Affiliations
    Department of Surgery
    Document Type
    Journal Article
    Publication Date
    2017-04-01
    Keywords
    Surgery
    
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    Link to Full Text
    https://doi.org/10.1016/j.jvs.2016.10.121
    Abstract
    BACKGROUND: This study determined the feasibility and potential efficacy of an evidence-based standardized smoking cessation intervention delivered by vascular surgeons to smokers with peripheral arterial disease. METHODS: We performed a cluster-randomized trial of current adult smokers referred to eight vascular surgery practices from September 1, 2014, to July 31, 2015. A three-component smoking cessation intervention (physician advice, nicotine replacement therapy, and telephone-based quitline referral) was compared with usual care. The primary outcome was smoking cessation for 7 days, assessed 3 months after the intervention. Secondary outcomes were patients' nicotine dependence and health expectancies of smoking assessed using Patient Reported Outcomes Measurement Information System (PROMIS; RAND Corporation, Santa Monica, Calif). RESULTS: We enrolled 156 patients (65 in four intervention practices, 91 in four control practices), and 141 (90.3%) completed follow-up. Patients in the intervention and control practices were similar in age (mean, 61 years), sex (68% male), cigarettes per day (mean, 14), and prior quit attempts (77%). All three components of the intervention were delivered to 75% of patients in intervention practices vs to 7% of patients at control practices (P < .001). At 3 months, 23 of 57 patients (40.3%) in the intervention group quit smoking (23 of 56 patients quit who completed follow-up, plus 1 death included in the analysis in the denominator as a smoker), and 26 of 84 patients (30.9%) In the control group quit smoking (26 patients of 84 who completed follow-up, including 2 deaths included in the denominator as smokers). This difference (40.3% quit rate in intervention, 31% quit rate in control; P = .250) was not statistically significant in crude analyses (P = .250) or analyses adjusted for clustering (P = .470). Multivariable analysis showed factors associated with smoking cessation were receipt of physician advice (odds ratio for cessation, 1.96; 95% confidence interval, 1.28-3.02; P < .002) and nicotine replacement therapy (odds ratio, 1.92; 95% confidence interval, 1.43-2.56; P < .001). CONCLUSIONS: Implementation of a brief, surgeon-delivered smoking cessation intervention is feasible for patients with peripheral arterial disease. A larger trial will be necessary to determine whether this is effective for smoking cessation.
    Source
    J Vasc Surg. 2017 Apr;65(4):1152-1160.e2. doi: 10.1016/j.jvs.2016.10.121. Epub 2017 Feb 9. Link to article on publisher's site
    DOI
    10.1016/j.jvs.2016.10.121
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29104
    PubMed ID
    28190719
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jvs.2016.10.121
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