Prevalence and Predictors of Smoking by Inpatients During a Hospital Stay

Regan, Susan; Viana, Joseph C.; Reyen, Michele; Rigotti, Nancy A.

doi:10.1001/2013.jamainternmed.300

Cited by 25 publications

(26 citation statements)

References 20 publications

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“…Additionally, adults who smoke tobacco may receive nicotine replacement therapy (NRT) in the hospital to reduce nicotine withdrawal symptoms, providing them an opportunity to sample an evidence-based FDAapproved cessation therapy. Patients who use NRT in the hospital are more likely to continue using it after discharge [3].…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of post-discharge strategies for hospitalized smokers: Study protocol for the Helping HAND 4 randomized controlled trial

Rigotti

Schnitzer

Davis

et al. 2020

Trials

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Background: Tobacco smoking remains the leading preventable cause of death in the US. A hospital admission provides smokers with a unique opportunity to stop smoking because it requires temporary tobacco abstinence while illness may enhance motivation to quit. Hospital interventions must continue post-discharge to increase tobacco abstinence long-term, but how best to accomplish this remains unclear. Building on two previous randomized controlled trials, each of which tested smoking cessation interventions that began in hospital and continued after discharge, this trial compares two interventions that provide sustained smoking cessation treatment after hospital discharge with the goal of improving long-term smoking cessation rates among hospitalized smokers. Methods/design: Helping HAND 4 is a three-site randomized controlled trial that compares the effectiveness of two active interventions for producing validated past 7-day tobacco abstinence 6 months after hospital discharge. Smokers who are admitted to three hospitals receive a standard in-hospital smoking intervention, and those who plan to quit smoking after discharge are recruited and randomly assigned to two interventions that begin at discharge, Personalized Tobacco Care Management (PTCM) or Quitline eReferral. Each lasts 3 months. At discharge, PTCM provides 8 weeks of free nicotine replacement (NRT; a participant's choice of patch, gum, lozenge, or a combination) and then proactive smoking cessation support using an automated communication platform and live contact with a tobacco treatment specialist who is based in the health care system. In the eReferral condition, a direct referral is made from the hospital electronic health record to a community-based resource, the state's telephone quitline. The quitline provides up to 8 weeks of free NRT and offers behavioral support via a series of phone calls from a trained coach. Outcomes are assessed at 1, 3, and 6 months after discharge. The study hypothesis is that PTCM will produce higher quit rates than eReferral.

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Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of post-discharge strategies for hospitalized smokers: Study protocol for the Helping HAND 4 randomized controlled trial

Rigotti

Schnitzer

Davis

et al. 2020

Trials

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“…Evidence from general medical settings suggests that smoking during hospitalization is more common among those with higher cravings to smoke and lower among those who use NRT during admission (Regan et al . ). Paired with the current findings, such research suggests that if mental health nursing staff and other treating medical staff including psychologists and psychiatrists provided adequate doses of NRT to patients who smoke, it may both improve patient adherence to a smoking ban, and improve patient acceptability of a smoke‐free hospital admission.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a smoke‐free policy in an inpatient psychiatric facility: Patient‐reported adherence, support, and receipt of nicotine‐dependence treatment

Stockings

Bowman

Bartlem

et al. 2015

Int J Mental Health Nurs

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The implementation of smoke-free policies in inpatient psychiatric facilities, including patient adherence, mental health nursing staff support, and provision of nicotine-dependence treatment to patients, has been reported to be poor. The extent to which the quality of smoke-free policy implementation is associated with patient views of a policy is unknown. We conducted a cross-sectional survey of 181 patients (53.6%, n = 97 smokers; and 46.4%, n = 84 non-smokers) in an Australian inpatient psychiatric facility with a total smoke-free policy. Smokers' adherence to the policy was poor (83.5% smoked). Only half (53.6%) perceived staff to be supportive of the policy. Most smokers used nicotine-replacement therapy (75.3%); although few received optimal nicotine-dependence treatment (19.6%). Overall, 45.9% of patients viewed the smoke-free policy in the unit as positive (29.9% smokers; 64.3% non-smokers). For smokers, adhering to the ban, perceiving staff to be supportive, and reporting that the nicotine-replacement therapy reduced cravings to smoke were associated with a more positive view towards the smoke-free policy. These findings support the importance of patient adherence, mental health nursing staff support, and adequate provision of nicotine-dependence treatment in strengthening smoke-free policy implementation in inpatient psychiatric settings.

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“…The 2011–2012 national data show that males are more likely to smoke than females, the majority (89%) of people aged 15–17 years have never smoked, and smoking rates among young people (18–24 years) are also in decline 1. However, US data suggest that younger patients (less than 50 years) are more likely to smoke during their hospital stay 19. The increased prevalence of smoking among younger people and females in this study may be due to more participation from these groups during the survey.…”

Section: Discussionmentioning

confidence: 63%

Smoking behavior among patients and staff: a snapshot from a major metropolitan hospital in Melbourne, Australia

Rahman

Wilson

Sanders

et al. 2014

IJGM

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BackgroundA cross-sectional study was conducted to provide a snapshot of smoking behavior among staff and patients at a major metropolitan hospital in Melbourne.MethodsPatients and staff were surveyed using a questionnaire exploring demographics, nicotine dependence (Fagerstrom test), readiness to quit, and preference for smoking cessation options.ResultsA total of 1496 people were screened within 2 hours; 1,301 participated (1,100 staff, 199 patients). Mean age was 42 years, 68% were female. There were 113 (9%) current smokers and 326 (25%) ex-smokers. Seven percent of the staff were current smokers compared with 19% of the patients. The Fagerstrom test showed that 47% of patients who smoked were moderately nicotine dependent compared with 21% of staff. A third of the staff who smoked did not anticipate health problems related to smoking. Most patients (79%) who smoked disagreed that their current health problems were related to smoking. Although more than half of the current smokers preferred pharmacotherapy, one in two of them did not prefer behavior counseling; with consistent results among staff and patients. Multivariate analyses showed that patients were three times more likely (odds ratio 3.0, 95% confidence interval 1.9–4.7) to smoke than staff.ConclusionThis study reports lower prevalence of smoking among hospital staff compared with national data. It also indicates an under-appreciation of health effects of smoking, and a preference not to use conventional methods of quitting.

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Prevalence and Predictors of Smoking by Inpatients During a Hospital Stay

Cited by 25 publications

References 20 publications

Comparative effectiveness of post-discharge strategies for hospitalized smokers: Study protocol for the Helping HAND 4 randomized controlled trial

Comparative effectiveness of post-discharge strategies for hospitalized smokers: Study protocol for the Helping HAND 4 randomized controlled trial

Implementation of a smoke‐free policy in an inpatient psychiatric facility: Patient‐reported adherence, support, and receipt of nicotine‐dependence treatment

Smoking behavior among patients and staff: a snapshot from a major metropolitan hospital in Melbourne, Australia

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