Smoking Cessation Counseling Infrequent for Crohn Disease in Outpatient Setting

Smoking cessation education and counseling occurred infrequently among patients with Crohn disease (CD) in an outpatient setting, especially among individuals who are Hispanic, according to study results presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2022 conference, held from December 5 to 7, 2022, in Orlando, Florida.

Smoking is both a risk factor for developing CD and for poorer outcomes in terms of disease progression and flares. Guidelines recommend routine provision of smoking cessation counseling to mitigate the impact of smoking in patients with CD; however, little research has confirmed whether this recommendation is provided in outpatient settings.

Researchers at Thomas Jefferson University Hospital in Philadelphia conducted a nationwide retrospective analysis of the rates of tobacco cessation education during outpatient visits among individuals with CD.

They obtained data on outpatient visits from the National Ambulatory Medical Care Survey (NAMCS; 2002-2018) and the National Hospital Ambulatory Medical Care Survey (NHAMCS; 2002-2011) databases, identifying patients with CD using ICD-9 and ICD-10 codes.

Tobacco cessation counseling occurred in only 2.0% of total outpatient visits for patients with CD (95% CI, 1.1-3.5). Counseling rates for smoking cessation increased to 5.4% among former or current smokers (95% CI, 2.9-10.0). Interestingly, rates of smoking cessation counseling did not differ significantly between smokers and nonsmokers (P =.26).

When analyzing the rate of tobacco education and smoking cessation counseling based upon variables such as age, race, insurance type, and geographic location, the researchers discovered that smoking cessation counseling was less likely performed at outpatient visits with patients who are Hispanic compared with those who are White, non-Hispanic (adjusted odds ratio [aOR], 0.06; 95% CI, 0.01-0.30).

Overall, the researchers found that in outpatient visits for CD, counseling and education for smoking cessation rates were infrequent.

“Though smoking has an important role in disease course and development, these findings indicate that education on smoking cessation does not frequently occur in the outpatient setting for CD patients,” the researchers stated. “Overall, this highlights the need for increased focus by providers on screening and counseling for tobacco cessation in CD patients.”