Presentation Details
| From Advice to Action: Integrating a Smoking Cessation Referral into the Preoperative Evaluation Clinic at VCU Health - Pilot Study Shilpa Jasti1, 2, Sebastian Gutierrez1, 2, Dean Zhang1, 2, Olga Suarez-Winowiski1. 1VCU Department of Anesthesiology, Richmond, VA, USA.2VCU School of Medicine, Richmond, VA, USA |
Abstract
BACKGROUND: Smoking is a major modifiable risk factor for perioperative morbidity, contributing to impaired wound healing, pulmonary and cardiovascular complications, and delayed recovery. In Virginia, tobacco use contributes to more than 19,000 deaths annually and significantly increases the risk of COPD, myocardial infarction, and strokes. The preoperative period offers a distinctive “teachable moment” when patients are more receptive to health interventions. The Preoperative Assessment, Communication, and Education (PACE) Clinic within the Department of Anesthesiology at VCU partnered with the We CAN (Conquer Addiction to Nicotine) Quit program to pilot an integrated referral workflow promoting smoking cessation during pre-anesthesia evaluations.
PURPOSE: From June to July 2025, patients who self-reported active smoking or recent cessation were identified and offered information about the We CAN Quit program, which provides free personalized counseling via telehealth or in-person visits along with nicotine replacement therapy. Advanced practice providers were trained in the Ask-Advise-Connect model to introduce the program, obtain consent, and document acceptance. Patients who accepted materials were categorized as Flyer Given, and those who declined as Refusal. Clinical and demographic data were verified through the electronic health record.
RESULTS: Thirty patients met inclusion criteria (56.7% male, 43.3% female). Nineteen (63.3%) accepted cessation materials, eleven (36.7%) declined, and five (16.7%) had recently quit. Many patients had multiple chronic conditions, most commonly cardiovascular and pulmonary disease including COPD or asthma, reflecting a medically complex surgical population. No patients scheduled counseling at the visit.
CONCLUSIONS: Integrating a structured cessation referral into pre-anesthesia evaluation is feasible and well received. The high acceptance rate indicates patient openness when framed in the context of surgical readiness, though willingness to engage may require follow-up outreach beyond the initial visit. This pilot demonstrates a practical, scalable workflow that can support perioperative risk reduction and promote long-term health beyond the surgical encounter.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
PURPOSE: From June to July 2025, patients who self-reported active smoking or recent cessation were identified and offered information about the We CAN Quit program, which provides free personalized counseling via telehealth or in-person visits along with nicotine replacement therapy. Advanced practice providers were trained in the Ask-Advise-Connect model to introduce the program, obtain consent, and document acceptance. Patients who accepted materials were categorized as Flyer Given, and those who declined as Refusal. Clinical and demographic data were verified through the electronic health record.
RESULTS: Thirty patients met inclusion criteria (56.7% male, 43.3% female). Nineteen (63.3%) accepted cessation materials, eleven (36.7%) declined, and five (16.7%) had recently quit. Many patients had multiple chronic conditions, most commonly cardiovascular and pulmonary disease including COPD or asthma, reflecting a medically complex surgical population. No patients scheduled counseling at the visit.
CONCLUSIONS: Integrating a structured cessation referral into pre-anesthesia evaluation is feasible and well received. The high acceptance rate indicates patient openness when framed in the context of surgical readiness, though willingness to engage may require follow-up outreach beyond the initial visit. This pilot demonstrates a practical, scalable workflow that can support perioperative risk reduction and promote long-term health beyond the surgical encounter.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
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