Web-Based Intervention for Transitioning Smokers From Inpatient to Outpatient Care An RCT (original) (raw)
Related papers
Trials, 2012
Nicotine patches and quitline counseling to help hospitalized smokers stay quit: Study protocol for a randomized controlled trial Permalink https://escholarship.org/uc/item/6c00n0bg Journal Trials,(1) Abstract Background: Hospitalized smokers often quit smoking, voluntarily or involuntarily; most relapse soon after discharge. Extended follow-up counseling can help prevent relapse. However, it is difficult for hospitals to provide follow-up and smokers rarely leave the hospital with quitting aids (for example, nicotine patches). This study aims to test a practical model in which hospitals work with a state cessation quitline. Hospital staff briefly intervene with smokers at bedside and refer them to the quitline. Depending on assigned condition, smokers may receive nicotine patches at discharge or extended quitline telephone counseling post-discharge. This project establishes a practical model that lends itself to broader dissemination, while testing the effectiveness of the interventions in a rigorous randomized trial. Methods/design: This randomized clinical trial (N = 1,640) tests the effect of two interventions on long-term quit rates of hospitalized smokers in a 2 x 2 factorial design. The interventions are (1) nicotine patches (eight-week, step down program) dispensed at discharge and (2) proactive telephone counseling provided by the state quitline after discharge. Subjects are randomly assigned into: usual care, nicotine patches, telephone counseling, or both patches and counseling. It is hypothesized that patches and counseling have independent effects and their combined effect is greater than either alone. The primary outcome measure is thirty-day abstinence at six months; a secondary outcome is biochemically validated smoking status. Cost-effectiveness analysis is conducted to compare each intervention condition (patch alone, counseling alone, and combined interventions) against the usual care condition. Further, this study examines whether smokers' medical diagnosis is a moderator of treatment effect. Generalized linear (binomial) mixed models will be used to study the effect of treatment on abstinence rates. Clustering is accounted for with hospital-specific random effects.
Addiction Science & Clinical Practice
BackgroundA cessation program for hospitalized smokers is an effective strategy to achieve smoking abstinence. The effects of multiple in-hospital counseling sessions on 6-month smoking abstinence require further investigation.MethodsWe retrospectively analyzed the data of smokers who participated in hospital-initiated cessation programs at a medical center between 2017 and 2019. Data on age, sex, comorbidities, daily number of cigarettes, cessation motivation, nicotine dependence, cessation medications, discharge diagnosis, length of hospitalization, and intensive care unit admission were collected. We conducted multiple logistic regression analysis to investigate the effect of multiple in-hospital counseling sessions on 6-month sustained smoking abstinence. Sensitivity analyses were carried out excluding participants who underwent post-discharge cessation programs and assuming that the loss to follow-up participants had failure in 6-month smoking abstinence.ResultsA total of 1943 ...
Smoking Cessation After Hospital Discharge: Factors Associated With Abstinence
Journal of hospital medicine, 2018
Hospitalization offers tobacco smokers an opportunity to quit smoking, but factors associated with abstinence from tobacco after hospital discharge are poorly understood. We analyzed data from a multisite, randomized controlled trial testin a smoking cessation intervention for 1,357 hospitalized cigaretts smokers who planned to quit. Using multiple logistic regression, we assessed factors identifiable in the hospital that were independently associated with biochemically confirmed tobacco abstinence 6 months after discharge. Biochemically confirmed abstinence at 6 months (n = 218, 16%) was associated with a smoking-related primary discharge diagnosis (Adjusted Odds Ratio [AOR] = 1.98, 95% CI: 1.41-2.77), greater confidence in the ability to quit smoking (AOR - 1.31, 95% CI: 1.07-1.60), and stronger intention to quit (plan to quit after discharge vs. try to quit; AOR = 1.68, CI: 1.19-2.38). In conclusion, smokers hospitalized with a tobacco-related illness and those with greater confi...
Comparison of two smoking cessation interventions for inpatients
Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
This study aimed to compare the effectiveness of two cognitive behavioral therapy-based smoking cessation interventions initiated during hospitalization and to evaluate the factors related to relapse after discharge. This was a prospective randomized study involving 90 smokers hospitalized in a university hospital. We collected data related to sociodemographic characteristics, reasons for admission, smoking-related diseases, smoking history, the degree of nicotine dependence (ND), and the level of craving. Patients were divided into two treatment groups: brief intervention (BrInter, n = 45); and intensive intervention with presentation of an educational video (InInterV, n=45). To assess relapse, all patients were assessed by telephone interview in the first, third, and sixth months after discharge. Abstinence was confirmed by measurement of exhaled carbon monoxide (eCO). Of the 90 patients evaluated, 55 (61.1%) were male. The mean age was 51.1 ± 12.2 years. The degree of ND was elev...
Abstract Hospitalisation is an ideal time to implement smoking cessation interventions, and brief cessation advice from healthcare practitioners increase quit rates among hospitalised smokers. However, little is known about the extent inpatients receive such advice, or the impact it has on motivation to quit and quitting behaviours post-hospitalisation. This study aimed to determine the prevalence of smoking and cessation advice received by in-patients in two teaching hospitals in Ireland, and the impact of same 3-months post-discharge. Methods We surveyed 1001 in-patients across two hospital sites, over a six month period. Demographic details, clinical history, smoking history, motivation to quit, cigarette dependence and recent quitting history were assessed. Telephone follow-up at 3-months post-hospitalisation was used to establish post-discharge motivation to quit and establish smoking behaviours and quit attempts. A sample of self-reported quitters were asked to provide a breath sample using a carbon monoxide monitor (CO) to objectively assess smoking status at 3-months. Results Prevalence of smoking within the sample was 23.4% (235/1001). Only 32% (75/235) of smokers reported that smoking cessation was discussed during admission. Patient smoking status was documented in the records of 57% (132/235) of smokers. Smokers’ mean Fagerstrom nicotine dependence score was 3.7 (SD=2.7), indicating low dependence levels. At 3 months, 17% (25/146) of smokers reported smoking cessation, with 68% confirmed on CO test (17/25). Provision of smoking cessation advice during hospitalisation was associated with higher motivation to quit (OR=2.79, 95% CI 2.12-3.68), and successful quit behaviour (OR=2.02, 95% CI 1.34-3.06). Conclusions The current study finds that provision of brief cessation advice and smoking status documentation is suboptimal in two hospitals in Ireland. Where advice was given, it was associated with enhanced motivation to quit and increased quit rates. These findings, along with low average nicotine dependence scores in smokers, suggest that systematic provision of low-intensity cessation interventions could significantly enhance quit rates in hospitalised smokers.
Evaluation of a (pilot) stage-tailored brief smoking cessation intervention among hospital patients
Australian Health Review, 2000
Despite the significant benefits of advising all smokers to quit, hospital patients who smoke do not systematically receive this advice. This study sought to determine the prevalence of smoking, attitudes of patients towards not smoking while in hospital, and the feasibility and effectiveness of a brief smoking cessation intervention in a preadmission clinic context. Over 230 smokers received a brief smoking cessation intervention, while a control group (n=114) received only a free Quit Kit. The age-standardised smoking prevalence was 19%; a further 3% of patients were recent quitters. Most smokers do not expect or experience problems with not smoking while in hospital. Brief smoking cessation advice tailored to stage-of-change by a health worker in a hospital pre-admission clinic significantly increased the quit rates for females.
Helping Hospitalized Smokers: A Factorial RCT of Nicotine Patches and Counseling
American journal of preventive medicine, 2016
Most smokers abstain from smoking during hospitalization but relapse upon discharge. This study tests the effectiveness of two proven treatments (i.e., nicotine patches and telephone counseling) in helping these patients stay quit after discharge from the hospital, and assesses a model of hospital-quitline partnership. This study had a 2×2 factorial design in which participants were stratified by recruitment site and smoking rate and randomly assigned to usual care, nicotine patches only, counseling only, or patches plus counseling. They were evaluated at 2 and 6 months post-randomization. A total of 1,270 hospitalized adult smokers were recruited from August 2011 to November 2013 from five hospitals within three healthcare systems. Participants in the patch condition were provided 8 weeks of nicotine patches at discharge (or were mailed them post-discharge). Quitline staff started proactively calling participants in the counseling condition 3 days post-discharge to provide standard...
A Post-Discharge Smoking-Cessation Intervention for Hospital Patients
American Journal of Preventive Medicine, 2016
Introduction-Hospitalization provides an opportunity for smokers to quit, but tobaccocessation interventions started in hospital must continue after discharge to be effective. This study aimed to improve the scalability of a proven effective post-discharge intervention by incorporating referral to a telephone quitline, a nationally available cessation resource. Study design-A three-site RCT compared Sustained Care, a post-discharge tobacco-cessation intervention, with Standard Care among hospitalized adult smokers who wanted to quit smoking and received in-hospital tobacco-cessation counseling.