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

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. UROLOGY 180: 14-20, 2023.(c) 2023 Elsevier Inc. All rights reserved.

Automated summary

This study aimed to assess urologists' perceptions and practices related to smoking and smoking cessation. The results of the survey showed that most urologists recognized the significant contribution of cigarette smoking to urologic disease, but there was a low level of agreement on the importance of tobacco use assessment and treatment in urology clinics. Furthermore, when advising patients who smoke, urologists tended to not provide additional counseling or medications and faced various barriers such as lack of time, patient unwillingness to quit, and discomfort in prescribing cessation medications.