Rohrer LD (Durham VA), Stechuchak KM
(Durham VA), Almirall D
(Durham VA), Fish LJ
(Durham VA), Bastian LA
Traditional VA smoking cessation clinics reach less than 5% of veterans who continue to smoke after a diagnosis of cancer or heart disease. The objective of this analysis was to describe proactive enrollment of chronically ill veterans into an ongoing telephone-based smoking cessation trial called “Family Matters.”
Patients treated for cancer or heart disease within the prior three months were identified from the Durham VA using the hospital’s computerized medical record. Records were screened for smoking status and recent smokers were mailed an introductory letter from the Chief of Cardiology or Oncology informing them of the study and encouraging smoking cessation. Patients were informed that the study would be telephone-based and include five counseling sessions. Patients were then called to assess eligibility criteria that included smoking at least seven cigarettes in the past seven days and wanting to quit in the next 30 days. Eligible patients were invited to enroll in the ongoing Family Matters study. Patient characteristics (e.g., mean age and percent male, married, African-American, with heart disease) were calculated by enrollment versus refusal status.
Overall, we identified 2,181 patients with cancer or heart disease as of September 2008, and 1,390 were removed during the screening process using medical record abstraction. 791 were mailed an introductory letter. We attempted to call these veterans to participate in the study. We were unable to contact 165 veterans, and 199 were not eligible (i.e., already stopped smoking or too ill to participate). Of the eligible 427 patients contacted, 156 (37%) enrolled in the smoking cessation program. The following differences in enrollment compared to refusal to participate were noted: by age (61 vs. 62 years), male gender (98% vs. 97%), currently married (51% vs. 55%), African-American (29% vs. 19%), and heart disease (51% vs. 45%).
Thirty-seven percent of eligible veterans diagnosed with cancer or heart disease agreed to enroll in a telephone-based smoking cessation study.
Telephone-based smoking interventions appear to increase the reach of veterans who smoke and do not differ by age, gender, marriage status, race, or disease type.