Effectiveness of a low-intensity smoking cessation intervention for hospitalized patients.

Abstract

Debate exists about how intense smoking cessation interventions for hospitalized patients should be. In this study we assessed the effectiveness of a low-intensity smoking cessation intervention for hospitalized patients, without follow-up phone calls. We designed a cohort study with a historical control group, in the Department of Medicine of an 850-bed teaching hospital. One hundred and seventeen consecutive eligible smokers received the intervention, and 113 smokers hospitalized before the implementation of the intervention constituted the historical control group. The 30-min smoking cessation intervention was performed by a trained resident without any follow-up contact. Counseling was matched to smokers' motivation to quit, and accompanied by a self-help booklet. Nicotine replacement therapy was prescribed when indicated. All patients received a questionnaire to evaluate their smoking habits 6 months after they left hospital. We counted patients lost to follow-up as continuous smokers and smoking abstinence was validated by patients' physicians. Validated smoking cessation rates were 23.9% in the intervention group and 9.7% in the control group (odds ratio 2.9, 95% confidence interval: 1.4-6.2). After adjusting for potential confounders, intervention was still effective with an adjusted odds ratio of 2.26 (95% confidence interval: 1.04-4.95). Among those who continued to smoke 6 months after hospitalization, the likelihood of reporting any decrease of cigarette consumption was higher in the intervention cohort (70.8 vs. 42.7%, P=0.001). A low-intensity smoking cessation intervention, based on two visits without any follow-up contact, is associated with a higher quit rate at 6 months than that for historical control patients. Our findings show that a low-intensity smoking cessation intervention, based on two visits without any follow-up contact, is associated with a higher quit rate at 6 months than that for historical control patients.