Effectiveness of immediate appointment scheduling in smoking cessation clinics for patients with chronic airway diseases: Preliminary results from a randomized trial

Abstract

INTRODUCTION Patients with airway diseases who bear the burden of smoking need access to smoking cessation support. We aimed to investigate the impact of immediately scheduled appointments on access to smoking cessation clinics compared with usual care in this patient group. METHODS This multicenter, prospective, randomized, open-label study was conducted between November 2022 and June 2023 at pulmonary outpatient clinics. The study included adult patients who were current smokers and had a diagnosis of asthma, COPD, or bronchiectasis for at least six months. Sequentially randomization was used for the allocation of patients in a 1:1 ratio to two study arms: the usual support arm (representing the current standard care procedure) and the immediate support arm (involving intensive brief cessation advice followed by the immediate arrangement of an appointment at the same clinic's smoking cessation service). After one week, both patient groups were contacted by phone to assess their quit attempts and whether they had sought assistance from smoking cessation outpatient clinics (SCCs). RESULTS A total of 397 patients were enrolled in the study, with 199 allocated to the usual support arm and 198 allocated to the immediate support arm. Within the first week, 18.1% of patients in the usual support arm and 77.3% of patients in the immediate support arm sought assistance from the smoking cessation clinic (p<0.001). The rate of smokers without an intention to quit was 56.7% in the usual support arm and 27.7% in the immediate support arm in the first week of follow-up. Immediate appointment scheduling was significantly associated with a 13-fold (OR=13.38; 95% CI: 8.00–22.38) increase in referral rates in the multivariate logistic regression model. CONCLUSIONS Arranging instant appointments has increased access to SCCs by 13 times compared to the usual care, this group of patients should be given an immediate appointment to SCCs.