Background: Repeated large-scale studies have reinforced our understanding of smoking as the likely single most important modifiable risk factor affecting health and longevity. Although medical students receive instruction on how to navigate lifestyle change conversations with patients, specific education on how to perform smoking cessation counseling may be very minimal in the pre-clinical years. While the rates of smoking within the general US population have dropped to around 12% as of 2021, individuals undergoing substance use disorder treatment have rates of smoking as high as 80%. As New Orleans Bridge House (NOBH) works with individuals undergoing rehabilitation from substance use disorder, volunteers should be equipped to engage in smoking cessation discussions on every shift. Our analysis evaluates the efficacy of implementing a 15-minute pre-shift training on smoking cessation counseling for all medical student volunteers.

Methods: The smoking cessation volunteer training takes place in the 15 minutes preceding the volunteer's shift. The on-shift leader first facilitates an open discussion on smoking cessation between all volunteers to gauge the level of knowledge and experience with the content. Focus areas are divided into cessation aids (ex., specific medications) and conversational techniques (ex. motivational interviewing). Next, an info sheet from NY.gov contains details about all FDA-approved pharmaceutical interventions for smoking cessation. The leader then guides all volunteers through a review of the information, ensuring to answer all volunteer questions. 4th year student volunteers were encouraged to provide advice based on their experiences in clinic rotations. 1st-year students are then encouraged to complete a 5-question electronic survey emailed one and three days after their volunteer shift.

Results: Between 8/16/2023-9/27/2024, 45 responses were received from approximately 106 volunteers, yielding a response rate of 42%. 64% of students reported discussing smoking cessation with a patient during their shift. In response to whether the pre-shift discussion helped their ability to address this topic with patients, 62% answered “definitely yes,” and 26% answered “somewhat yes,” with no students reporting that the session was unhelpful. Out of the list of cessation aids discussed during the training, the three that students were least aware of were nicotine nasal spray (64% unaware), combination nicotine replacement therapy (45%), and nicotine lozenges (42%).

Conclusion: The majority of medical student volunteers at NOBH engage in smoking cessation discussion with a patient during each shift. Nearly every surveyed volunteer believed they benefited from brief pre-shift training and the majority learned about at least one new cessation aid. Further investigation is needed to evaluate patients’ perceptions of these conversations and outcomes with regards to long term smoking cessation.