Efficacy of a smoking cessation program for hospital patients

Nancy A. Rigotti, Julia H. Arnsten, Kathleen M. McKool, Kristen M. Wood-Reid, Richard C. Pasternak, Daniel E. Singer

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Background. Hospitalization may be an opportune time to change smoking behavior because it requires smokers to abstain from tobacco at the same time that illness can motivate them to quit. A hospital-based intervention may promote smoking cessation after discharge. Methods: We tested the efficacy of a brief bedside smoking counseling program in a randomized controlled trial at Massachusetts General Hospital, Boston. The 650 adult smokers admitted to the medical and surgical services were randomly assigned to receive usual care or a hospital-based smoking intervention consisting of (1) a 15-minute beside counseling session, (2) written self-help material, (3) a chart prompt reminding physicians to advise smoking cessation, and (4) up to 3 weekly counseling telephone calls after discharge. Smoking status was assessed 1 and 6 months after hospital discharge by self-report and validated at 6 months by measurement of saliva continue levels. Results: One month after discharge, more intervention than control patients were not smoking (28.9% vs 18.9; P=.033). The effect persisted after multiple logistic regression analyses adjusted for baseline group differences, length of stay, postdischarge smoking treatment, and hospital readmission (adjusted odds ratio, 2.19; 95% confidence interval, 1.34-3.57). At 6 months, the intervention and control groups did not differ in smoking cessation rate by self-report (17.3% vs 14.0%; P =.26) or biochemical validation (8.1% vs 8.7%; P =.72), although the program appeared to be effective among the 167 patients who had not previously tried to quit smoking (15.3% vs 3.7%; P=.01). Conclusions: A low- intensity, hospital-bases smoking cessation program increased smoking cessation rates for 1 month after discharge but did not lead to long-term tobacco abstinence. A longer period of telephone contact after discharge might build on this initial success to produce permanent smoking cessation among hospitalized smokers.

Original languageEnglish (US)
Pages (from-to)2653-2660
Number of pages8
JournalArchives of Internal Medicine
Volume157
Issue number22
StatePublished - 1997
Externally publishedYes

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Smoking Cessation
Smoking
Counseling
Telephone
Self Report
Tobacco
Patient Readmission
Saliva
General Hospitals
Length of Stay
Hospitalization
Randomized Controlled Trials
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals
Physicians
Control Groups

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Rigotti, N. A., Arnsten, J. H., McKool, K. M., Wood-Reid, K. M., Pasternak, R. C., & Singer, D. E. (1997). Efficacy of a smoking cessation program for hospital patients. Archives of Internal Medicine, 157(22), 2653-2660.

Efficacy of a smoking cessation program for hospital patients. / Rigotti, Nancy A.; Arnsten, Julia H.; McKool, Kathleen M.; Wood-Reid, Kristen M.; Pasternak, Richard C.; Singer, Daniel E.

In: Archives of Internal Medicine, Vol. 157, No. 22, 1997, p. 2653-2660.

Research output: Contribution to journalArticle

Rigotti, NA, Arnsten, JH, McKool, KM, Wood-Reid, KM, Pasternak, RC & Singer, DE 1997, 'Efficacy of a smoking cessation program for hospital patients', Archives of Internal Medicine, vol. 157, no. 22, pp. 2653-2660.
Rigotti NA, Arnsten JH, McKool KM, Wood-Reid KM, Pasternak RC, Singer DE. Efficacy of a smoking cessation program for hospital patients. Archives of Internal Medicine. 1997;157(22):2653-2660.
Rigotti, Nancy A. ; Arnsten, Julia H. ; McKool, Kathleen M. ; Wood-Reid, Kristen M. ; Pasternak, Richard C. ; Singer, Daniel E. / Efficacy of a smoking cessation program for hospital patients. In: Archives of Internal Medicine. 1997 ; Vol. 157, No. 22. pp. 2653-2660.
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abstract = "Background. Hospitalization may be an opportune time to change smoking behavior because it requires smokers to abstain from tobacco at the same time that illness can motivate them to quit. A hospital-based intervention may promote smoking cessation after discharge. Methods: We tested the efficacy of a brief bedside smoking counseling program in a randomized controlled trial at Massachusetts General Hospital, Boston. The 650 adult smokers admitted to the medical and surgical services were randomly assigned to receive usual care or a hospital-based smoking intervention consisting of (1) a 15-minute beside counseling session, (2) written self-help material, (3) a chart prompt reminding physicians to advise smoking cessation, and (4) up to 3 weekly counseling telephone calls after discharge. Smoking status was assessed 1 and 6 months after hospital discharge by self-report and validated at 6 months by measurement of saliva continue levels. Results: One month after discharge, more intervention than control patients were not smoking (28.9{\%} vs 18.9; P=.033). The effect persisted after multiple logistic regression analyses adjusted for baseline group differences, length of stay, postdischarge smoking treatment, and hospital readmission (adjusted odds ratio, 2.19; 95{\%} confidence interval, 1.34-3.57). At 6 months, the intervention and control groups did not differ in smoking cessation rate by self-report (17.3{\%} vs 14.0{\%}; P =.26) or biochemical validation (8.1{\%} vs 8.7{\%}; P =.72), although the program appeared to be effective among the 167 patients who had not previously tried to quit smoking (15.3{\%} vs 3.7{\%}; P=.01). Conclusions: A low- intensity, hospital-bases smoking cessation program increased smoking cessation rates for 1 month after discharge but did not lead to long-term tobacco abstinence. A longer period of telephone contact after discharge might build on this initial success to produce permanent smoking cessation among hospitalized smokers.",
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