Urologists' Perceptions and Practices Related to Patient Smoking and Cessation: A National Assessment From the 2021 American Urological Association Census

Richard S Matulewicz; William Meeks; Rachel Mbassa; Raymond Fang; Ashley Pittman; Matthew Mossanen; Helena Furberg; Lou-Anne Chichester; Michelle Lui; Scott E Sherman; Danil V Makarov; Marc A Bjurlin; Jamie S Ostroff

doi:10.1016/j.urology.2023.06.022

Urologists' Perceptions and Practices Related to Patient Smoking and Cessation: A National Assessment From the 2021 American Urological Association Census

Urology. 2023 Oct:180:14-20. doi: 10.1016/j.urology.2023.06.022. Epub 2023 Jul 6.

Authors

Affiliations

¹ Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: matulewr@mskcc.org.
² American Urological Association, Linthicum, MD.
³ Medical College of Wisconsin, Milwaukee, WI.
⁴ Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
⁵ Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
⁶ Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY.
⁷ Department of Population Heath, Grossman School of Medicine, New York University, New York, NY; Department of Medicine, VA New York Harbor Healthcare System, New York, NY.
⁸ Department of Urology, New York University, New York, NY.
⁹ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.

PMID: 37422137
PMCID: PMC10592412 (available on 2024-10-01)
DOI: 10.1016/j.urology.2023.06.022

Abstract

Objective: To assess urologists' perceptions and practices related to smoking and smoking cessation.

Materials and methods: Six survey questions were designed to assess beliefs, practices, and determinants related to tobacco use assessment and treatment (TUAT) in outpatient urology clinics. These questions were included in an annual census survey (2021) offered to all practicing urologists. Responses were weighted to represent the practicing US population of nonpediatric urologists (N = 12,852). The primary outcome was affirmative responses to the question, "Do you agree it is important for urologists to screen for and provide smoking cessation treatment to patients in the outpatient clinic?" Practice patterns, perceptions, and opinions of optimal care delivery were assessed.

Results: In total, 98% of urologists agreed (27%) or strongly agreed (71%) that cigarette smoking is a significant contributor to urologic disease. However, only 58% agreed that TUAT is important in urology clinics. Most urologists (61%) advise patients who smoke to quit but do not provide additional cessation counseling or medications or arrange follow-up. The most frequently identified barriers to TUAT were lack of time (70%), perceptions that patients are unwilling to quit (44%), and lack of comfort prescribing cessation medications (42%). Additionally, 72% of respondents stated that urologists should provide a recommendation to quit and refer patients for cessation support.

Conclusion: TUAT does not routinely occur in an evidence-based fashion in outpatient urology clinics. Addressing established barriers and facilitating these practices with multilevel implementation strategies can promote tobacco treatment and improve outcomes for patients with urologic disease.

Abstract

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