Integrating smoking cessation into routine care in hospitals—a randomized controlled trial

Thomas, Dennis; Abramson, Michael J.; Bonevski, Billie; Taylor, Simone E; Poole, SG; Paul, Eldho; Weeks, GR; Dooley, MJ; George, Johnson

doi:10.1111/add.13239

Cited by 23 publications

(20 citation statements)

References 27 publications

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“…31 A large study in primary care clinics found that less than 5% of smokers accepted a faxed referral to a state quitline. 33 In this study, acceptance rates were higher for outpatient counseling referrals (58%) and medications (43%), and 28% of patients accepted referrals for both counseling and medications. Patients in the current study may have been more interested in quitting or more familiar with cessation services, compared with previous studies.…”

Section: Discussionmentioning

confidence: 51%

“…This result was consistent with a recent trial of a pharmacist-led inpatient program combining counseling and medications (inpatient and post-discharge), which increased outpatient medications use compared with control (60% to 44%, p <0.001). 33 Reported medication receipt was lower across hospitals sites in the current study compared with the pharmacist-led program.…”

Section: Discussionmentioning

confidence: 59%

“…A study of Veterans Administration hospital patients found that less than 14% of smokers reported not smoking in the previous 7 days at 6-month follow-up, 32 whereas only 12% of patients in a pharmacist-led hospital program were abstinent (30-day) at 6 months. 33 Other studies achieved considerably higher quit rates. Reid and colleagues 34 implemented the “Ottawa Model” in nine Canadian hospitals.…”

Section: Discussionmentioning

confidence: 95%

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Referring Hospitalized Smokers to Outpatient Quit Services

Fellows

Mularski

Leo

et al. 2016

American Journal of Preventive Medicine

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Introduction Linking outpatient cessation services to bedside counseling for hospitalized smokers can improve long-run quit rates. Adding an assisted referral (AR) offer to a tobacco treatment specialist consult service fits the team approach to care in U.S. hospitals. Design A two-arm patient-randomized trial tested the effectiveness of adding an AR offer to outpatient smoking-cessation services and interactive voice recognition (AR+IVR) follow-up to a usual care (UC) tobacco-cessation consult for hospitalized smokers. Setting/participants Over 24 months (November 2011–November 2013), 898 hospitalized adult smokers interested in quitting smoking were recruited from three large hospitals in the Portland, Oregon area: an integrated group model HMO (n=622), a community hospital (n=195), and an academic health center (n=81). Intervention Tobacco treatment specialists identified smokers and provided an intensive bedside tobacco use assessment and cessation consultation (UC). AR+IVR recipients also received proactive ARs to available outpatient counseling programs and medications, and linked patients to a tailored IVR telephone follow-up system. Main outcome measures The primary outcome was self-reported 30-day abstinence at 6-month follow-up. Secondary outcomes included self-reported and continuous abstinence and biochemically confirmed 7-day abstinence at 6 months. Follow-up was completed in September 2014; data were analyzed in 2015. Results A total of 597 and 301 hospitalized smokers were randomized to AR+IVR and UC, respectively. AR+IVR and UC recipients received 19.3 and 17.0 minutes of bedside counseling (p=0.372), respectively. Most (58%) AR+IVR patients accepted referrals for counseling, 43% accepted medications, and 28% accepted both. Self-reported 30-day abstinence for AR+IVR (17.9%) and UC (17.3%) were not statistically significant (p=0.569). Differences in 7-day, continuous, and biochemically confirmed abstinence by treatment group also were insignificant, overall and adjusting for site. Conclusions Adding an AR to outpatient counseling and medications did not increase cigarette abstinence at 6 months compared to UC alone.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 95%

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Referring Hospitalized Smokers to Outpatient Quit Services

Fellows

Mularski

Leo

et al. 2016

American Journal of Preventive Medicine

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“…Various methods have been used to encourage people to quit smoking. One of these methods is smoking cessation counseling by nurse, physician or dentist and social workers [4][5][6]; data regarding the useful effects of smoking cessation counseling have been encouraging and multiple studies have shown higher quit rates in counseled versus noncounseled smokers [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Smoking-Cessation Counseling Based on the Stages-of-Change Model in Dental Patients; Semi-Experimental Study

Ghorbani

Hosseini

et al. 2019

Preprint

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Background Dentists may take part in smoking cessation counseling of dental patients by using the time they are engaged in dental procedures and by emphasizing on oral manifestations of smoking. The present study aimed to evaluate the effects of smoking cessation counseling by a dentist on preparation for change to quit smoking in smoker patients. Methods This study was performed on 150 smoking patients admitted to Dental School of Shahid Beheshti University of Medical sciences, Tehran, Iran. The patients were randomly divided into two groups of 75 patients. The intervention group received smoking cessation counseling by a single senior dental student. A self-administered questionnaire containing questions regarding the position of the individual in change cycle stages was completed by both intervention and control group at baseline and at one-month follow up. For statistical analysis, paired t-tests, Mann-Whitney U and multivariate linear regression models was used with a significance level of P<0.05. Results At baseline, there were no significant differences between the intervention and control groups in terms of change cycle stages of smoking cessation. Also, there was no significant difference between change cycle stages at baseline and one-month follow up in control group; but this difference in intervention group was significant (p=0.006). The proportion of patients in the pre-contemplation stage decreased by 43% while the proportion of patients in the contemplation and action stages increased by 20% and 16% respectively. Conclusions The smoking cessation counseling enhances forward movement through the stages-of-change of smoking cessation. Measurement of this movement may be an important intermediary in evaluating small clinical trials of counseling.

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“…Despite the well-documented benefits of addressing tobacco use in hospitals and providing follow-up support, adherence to clinical practice guidelines by health providers is less than optimal,17 18 with low levels of smoking cessation support provided if any 17 19. High-intensity hospital-based behavioural interventions which contain a post-discharge component of at least 1 month follow-up have been found to increase cessation rates by 37% at 6–12 months when compared with usual care 13.…”

Section: Introductionmentioning

confidence: 99%

Development of an online smoking cessation program for use in hospital and following discharge: smoke-free recovery

McCrabb¹,

Balogh

Baker³

et al. 2017

BMJ Innov

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Integrating smoking cessation into routine care in hospitals—a randomized controlled trial

Abstract: A pharmacist-led multi-component smoking cessation intervention provided during hospital stay did not improve sustained abstinence rates at either 6 or 12 months compared with routine hospital care.

Cited by 23 publications

References 27 publications

Referring Hospitalized Smokers to Outpatient Quit Services

Referring Hospitalized Smokers to Outpatient Quit Services

The Effects of Smoking-Cessation Counseling Based on the Stages-of-Change Model in Dental Patients; Semi-Experimental Study

Development of an online smoking cessation program for use in hospital and following discharge: smoke-free recovery

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