Background Smoking increases cardiovascular morbidity in patients with inflammatory rheumatic diseases, and has been associated with poor response to treatment in rheumatoid arthritis. Advice on smoking cessation is strongly recommended in patients with arthritis. Brief advice versus no advice increases the rate of quitting, thus doctors should aim to advise smokers to quit during routine consultations.
Objectives To understand the practice of rheumatologists and nurses regarding advice for smoking cessation in patients with arthritis.
Methods We sent a survey to the Rheumatology department participants in the multinational QUEST-RA group. The following items were included: a) number of rheumatologists in department, b) number of nurses for patient education, c) number of doctors and nurses who smoke, d) advice for smoking cessation by doctor and nurse, e) specific protocol for advice in the department, f) special clinic for quitting smoking in the hospital or primary care, and g) specific clinic for early arthritis and/or inflammatory diseases in the department.
Results Rheumatologists from 44 departments in 25 countries (16 European) completed the survey. The survey involved 395 rheumatologists of whom 25 (6.3%) smokers, and 199 nurses for patient education of whom 44 (22.1%) smokers. Eight departments (18.1%) had a specific protocol for smoking cessation (Table). 255 (64.5%) Rheumatologists reported giving advice to all or almost all smokers with inflammatory diseases. This advice was more frequent by doctors whose department includes an early arthritis clinic (71% vs 51%; p<0.001). However, advice by doctors was not related to the number of rheumatologists, other inflammatory clinics or having a specific protocol for smokers. The nurse give advice to most of patients (>80%) in 11 of the 35 (31.4%) departments with nurse for patient education. Rheumatologists in 19 of the 20 (95%) hospitals with specific clinic/unit for smoking cessation reported referring patients to these clinics if a patient asks for help or has lung disease or smoking-related comorbidities.
Conclusions Advice for smoking cessation within rheumatology departments is not homogeneous. Two thirds of rheumatologists give advice to quit smoking to all or almost all patients with inflammatory diseases. Only 1 in 5 departments have a specific protocol for smoking cessation. Our data highlights the need to improve awareness of importance and better practice implementation of smoking cessation advice for inflammatory rheumatic disease patients.
Disclosure of Interest None Declared