Evaluate the prevalence of smoking and tobacco treatment programs in Neurology subspecialty outpatient clinics at a large academic hospital.

There is a paucity of real-world data describing the proportion of tobacco use and tobacco cessation treatment in the outpatient neurology setting.

Adult patients who attended Washington University School of Medicine/Barnes-Jewish Hospital (WUSTL/BJH) Adult Neurology subspecialty outpatient clinics January 1 2022 through Dec 31 2022 were included. Information on smoking status and smoking cessation treatment programs (smoking cessation medications, brief advice and counseling on smoking cessation) were obtained via retrospective chart review of electronic health records. This data was compared to the WUSTL/BJH medical oncology clinics for the same time period.

Neurology outpatient clinics (10.6%, N=2,837) and Medical Oncology outpatient clinics (11.4%, N=3,330) had a similar proportion of smokers. Among the Neurology subspeciality clinics, the Resident-run clinic [33.5%, N=550) had by far the highest relative percentage of smokers, followed by the Neuro-ID/Autoimmune Neurology clinic [16.6%, N=80] and the Stroke clinic [15.1%, N=270]. The proportion of patients who smoked and received any type of smoking cessation treatment was lower in Neurology subspeciality clinics (26.7%, N=762) compared to Medical Oncology outpatient clinics (39.8%, N=1,326). Among Neurology outpatient clinics, the Resident-run clinic (56.6%, N=311) and the Multiple Sclerosis clinic (11.1%, N=27) had the highest and lowest percentage of smokers who received smoking cessation treatment, respectively.

The proportion of smokers that received smoking cessation treatment in Neurology outpatient clinics was consistently lower than those in Medical Oncology outpatient clinics. The proportion of smokers, and the proportion of smokers engaged in any type of smoking cessation treatment varied substantially across Neurology subspecialty outpatient clinics.  The Resident-run clinic had the highest proportion of both smokers, and smokers receiving smoking cessation treatment. Further analysis is being conducted to assess the reasons underpinning this variation.