Interventions for smoking cessation in hospitalised patients: a systematic review

Abstract

BACKGROUNDAn admission to hospital provides an opportunity to help people stop smoking. Individuals may be more open to help at a time of perceived vulnerability, and may find it easier to quit in an environment where smoking is restricted or prohibited. Providing smoking cessation services during hospitalisation may help more people to attempt and sustain an attempt to quit. The purpose of this paper is to systematically review the effectiveness of interventions for smoking cessation in hospitalised patients.METHODSWe searched the Cochrane Tobacco Addiction Group register, CINAHL, and the Smoking and Health database for studies of interventions for smoking cessation in hospitalised patients. Randomised and quasi-randomised trials of behavioural, pharmacological, or multi-component interventions to help patients stop smoking conducted with hospitalised patients who were current smokers or recent quitters were included. Studies of patients admitted for psychiatric disorders or substance abuse, those that did not report abstinence rates, and those with follow up of less than 6 months were excluded. Two of the authors extracted data independently for each paper, with assistance from others.RESULTSIntensive intervention (inpatient contact plus follow up for at least 1 month) was associated with a significantly higher cessation rate compared with controls (Peto odds ratio (OR) 1.82, 95% CI 1.49 to 2.22). Any contact during hospitalisation followed by minimal follow up failed to detect a statistically significant effect on cessation rate, but did not rule out a 30% increase in smoking cessation (Peto OR 1.09, 95% CI 0.91 to 1.31). There was insufficient evidence to judge the effect of interventions delivered only during the hospital stay. Although the interventions increased quit rates irrespective of whether nicotine replacement therapy (NRT) was used, the results for NRT were compatible with other data indicating that it increases quit rates. There was no strong evidence that clinical diagnosis affected the likelihood of quitting.CONCLUSIONSHigh intensity behavioural interventions that include at least 1 month of follow up contact are effective in promoting smoking cessation in hospitalised patients.

Assessing the Effect of an Inpatient Smoking Cessation Brief Intervention Tool on Long-Term Smoking Cessation Rates and Patient Interest for Nicotine Replacement Therapy: A Retrospective Analysis

“…They also highlight that the addition of NRT prescribing can further increase likelihood of smoking cessation post-discharge. These findings are compatible with an earlier systematic review which found that completion of hospital-based smoking cessation interventions was successful in increasing quit rates, whether or not NRT was used or prescribed [24]. Several studies indicate that hospital-based smoking cessation interventions are effective in increasing cessation rates when post-discharge follow-up is implemented or NRT use is encouraged [25‒27].…”

Smoking cessation management among Ibero-America’s cardiology residents

“…This is a true missed opportunity since multiple studies have shown that people who are hospitalized for a problem linked to tobacco addiction are more receptive when receiving advice to cease their addiction 25,26 . Furthermore, people who receive advice from health personnel to quit smoking manage to do it more frequently [25][26][27][28] . However, and paradoxically, a significant number of smokers do not receive interventions for quitting the habit, despite being in contact with health professionals 29 .…”

Faisabilité du dépistage systématique des comportements addictifs chez les patients hospitalisés

“…Des programmes d'aide au sevrage tabagique se sont donc adressés soit à des groupes ciblés (pathologies cardiaques en particulier), soit à l'ensemble des personnes hospitalisées. Ils se sont appuyés sur une intervention paramédicale après formation des personnels et ont témoigné d'une efficacité dans la prise en charge du tabagisme durant le séjour du patient [7,15,18,21,30].…”