Title: Feasibility and Pilot Efficacy of a Brief Smoking Cessation Intervention Delivered by Vascular Surgeons: The Vascular Physician Offer and Report (VAPOR) Trial
Abstract: The objective of this study was to determine the feasibility and potential efficacy of an evidence-based standardized smoking cessation intervention delivered by vascular surgeons to smokers with peripheral arterial disease. We performed a cluster-randomized trial of current adult smokers referred to eight vascular surgery practices from September 1, 2014, to July 31, 2015. We compared a three-component smoking cessation intervention (physician advice; nicotine replacement therapy; and telephone-based quitline referral) to usual care. The primary outcome was smoking cessation for 7 days, assessed 3 months after intervention. Secondary outcomes were patients' nicotine dependence and health expectancies of smoking, assessed using Patient-Reported Outcomes Measurement Information System. We enrolled 156 patients (65 in four intervention practices, 91 in four control practices), and 141 (90.3%) completed follow-up. Patients in 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 7% of patients at control practices (P < .001). At 3 months, 40% of patients in intervention practices reported smoking cessation vs 31% at control practices (P = .40). In multivariable analysis, 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; Figs 1 and 2). 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 if this is effective for smoking cessation.Fig 2Proportion achieving smoking cessation, by intervention and control status, assuming that patients missing follow-up (n = 15) are still smoking.View Large Image Figure ViewerDownload Hi-res image Download (PPT)