Audit of Smoking Status Documentation and Smoking Cessation Interventions in Psychiatric Inpatients Department of Psychiatry, Gulab Devi Teaching Hospital, Lahore
Muhammad Mansoor Ali, Syeda Areeba Siraj, Mudassar Ijaz, Ali Abbas Zahid, Maryam ArshadAims:
To assess documentation of smoking status on admission, delivery of smoking cessation interventions to current smokers, and identification of gaps in referral and follow-up among psychiatric inpatients, followed by implementation of targeted interventions and evaluation of improvement. Et al Authors: 6, Dr Muhammad Zubair (email:), General Practitioner, Lahore, Pakistan
Methods:
A closed-loop prospective clinical audit was conducted in the Psychiatry Department >over two cycles in 2 months. A total of 60 psychiatric inpatients were included, with 30 patients in each phase. Pre-intervention data were collected from admission clerking notes and inpatient records to assess smoking status documentation, brief cessation advice, nicotine replacement therapy (NRT), referral to smoking cessation services, and follow-up planning. Interventions included staff education, reminders during admission clerking, and emphasis on documenting smoking cessation measures. Post-intervention data were collected using the same standards to assess improvement.
Results:
Pre-intervention (n=30): Smoking status was documented in 66.7% of patients. Among identified current smokers (n=12), brief cessation advice was provided in 33.3%, NRT was offered in 25%, referral to smoking cessation services occurred in 8.3%, and a documented follow-up plan was present in 16.7%. Post-intervention (n=30): Smoking status documentation improved to 93.3% (absolute improvement +26.6%). Among current smokers (n=13), brief cessation advice increased to 84.6% (+51.3%), NRT provision to 76.9% (+51.9%), referral to smoking cessation services to 53.8% (+45.5%), and documentation of follow-up plans to 69.2% (+52.5%).
Conclusion:
This closed-loop audit demonstrated that baseline documentation of smoking status and delivery of smoking cessation interventions in psychiatric inpatients were initially suboptimal. Following targeted educational and system-based interventions, improvement was observed across all assessed domains, including smoking status documentation (+26.6%), provision of brief cessation advice (+51.3%), offering or prescription of NRT (+51.9%), referral to smoking cessation services (+45.5%), and documentation of follow-up plans (+52.5%). These findings highlight that structured interventions can significantly improve preventive cardiovascular risk management in psychiatric inpatient settings. Regular re-auditing is recommended to sustain compliance and embed smoking cessation as a routine component of inpatient psychiatric care.