Effect of clinician advice and patient preparedness to quit on subsequent quit attempts in hospitalized smokers

Abstract

BACKGROUND:Although smoking cessation counseling for cardiac inpatients is a quality measure, little data exist regarding postdischarge quit attempts in a primarily urban, African American, underserved population. This study aimed to assess preparedness to quit smoking and quit behaviors.METHODS:Smokers on the cardiology service were asked to rate preparedness using the 10‐step Contemplation Ladder. During phone surveys given 30‐days postdischarge, patients reported whether they made quit attempts, method and success of attempts, and recall of receiving advice to quit.RESULTS:From February 2006 through July 2007, 2906 of 3364 of inpatients were interviewed. Fifteen percent (436/2906) were current smokers and 415/436 completed the inpatient assessment. Of these, 75% (310/415) indicated they were prepared to quit. At the 1‐month follow‐up, 67% (276/415) were interviewed and 71% of those patients (195/276) reported making a quit attempt, with most (76%) reporting quitting “cold turkey” (without aid). Compared with less prepared patients, prepared patients were more likely to report making a quit attempt after discharge (77% [163/212] vs. 50% [32/64], P < 0.001) and were successful in that attempt (43% [90/212] vs. 25% [16/64], P = 0.010).CONCLUSIONS:The majority of smokers hospitalized with cardiac disease reported being prepared to quit smoking. Those prepared, and who received advice to quit, were more likely to make a quit attempt and report abstinence than those less prepared. However, most quit attempts were made using the least effective methods. Future studies in a population of primarily African American patients should assess preparedness to quit and target prepared patients with more effective interventions. Journal of Hospital Medicine 2010;5:26–32. © 2010 Society of Hospital Medicine.

Assessment of Variables Associated with Smoking Cessation in Crohn’s Disease

“…Baseline median score on the contemplation ladder tended to be higher for patients who reported smoking cessation at the 6-month follow-up. Previous work in patients with cardiovascular disease demonstrated that patients who identified themselves as being prepared to quit had a higher chance of smoking cessation [20]. Current smokers were more likely to have household contacts who smoked compared to ex-smokers.…”

A survey of the prevalence of smoking and smoking cessation advice received by inpatients in a large teaching hospital in Ireland

“…Hospitalised patient populations may be highly receptive to such advice, for example one large study revealed as many as 75% of cardiac in-patient smokers are prepared to quit [10]. Therefore, this opportunity while patients are under the care of medical teams should be used to help initiate this important risk factor control, especially as even brief advice may be effective [11].…”

Motivational Interviewing for Smoking Cessation and Increase of Physical Activity in Αdults

“…Interventions implemented in hospitals under the assumption that the patients may be more vulnerable, open and ready to quit smoking at that time, proved to be more effective (Rigotti, Munafo, D. Leontari et al Psychology & Stead, 2008) as the majority of the participants (75%) indicated readiness in quitting smoking. After being advised on smoking cessation, they exhibited increased successful effort probabilities and abstinence maintenance (Shah et al, 2010;Rigotti, Regan, Majchrzak, Knight, & Wechsler, 2002). However, the effectiveness of these interventions has suffered dispute by researchers who claimed that differences in quit rates are not significant (Hennrikus et al, 2005;Hjalmarson & Boethius, 2007).…”