1. Journal Club: Feasibility of Tobacco Interventions in Anesthesiology Practices
Troy Tada, DO
August 26, 2009

2. End points of Study
Determine if the AAR strategy will be well accepted into modern day anesthesiology practices

3. Choice of Article Many of our patients do smoke
Smoking does make an impact on our anesthetic plan
Smokers do have an increased risk for pulmonary complication with general anesthesia
What can we do to assist PCP with smoking cessation

4. Method 14 anesthesiology practices (academic-5 and private-9)
Implement AAR (ask, advise, refer) for 3 months
9 practices were presented with in-service training for rationale and strategy
5 practices received material to be distributed to staff

5. Method Two surveys given to all practices after 3 months 1st survey
Amount of time spent learning
Self-efficacy
Rate at which strategy was used
Attitude towards AAR
2nd survey
Number of docs in group received the 1st survey
Plans on continuing strategy

6. Results 95 completed surveys
76% physicians
Reported frequently or almost always performing each element of the AAR strategy
About 50% felt that their patient frequently or almost always seemed interested
33% interested in quitlines
90% respondents useful

7. results Majority  responsibility to advise pts to quit
Majority thought quitlines useful
23%  not enough time to apply strategy
Majority planned to utilize AAR in practice

8. Bottom line
AAR approach to tobacco intervention was well-accepted in anesthesiology practices

9. Limitations No follow up surveys
No studies showing which technique is most efficient
Most respondents did not receive formal training

10. What do we do? All ask if pt does smoke
Should we implement a smoking cessation intervention strategy
Alcohol
drugs

11. Open discussion