Phone and medication intervention increased smoking cessation after hospital discharge
A post-discharge intervention increased smoking cessation among recently hospitalized adults who wanted to quit, a recent study found.
A post-discharge intervention increased smoking cessation among recently hospitalized adults who wanted to quit, a recent study found.
Researchers randomized 397 hospitalized daily smokers who wanted to quit to either standard care (recommendations from an inpatient smoking counselor) or an intervention that included 90 days of free smoking cessation medication and automated interactive voice-response telephone calls. The mean age of participants was 53 years, 81% were non-Hispanic whites, and the study was conducted from August 2010 to November 2012 at Massachusetts General Hospital. Results were published in the Aug. 20 Journal of the American Medical Association.
At 6-month follow-up, patients in the intervention group had significantly higher rates of biochemically confirmed 7-day tobacco abstinence: 26% vs. 15% (relative risk, 1.71 [95% CI, 1.14 to 2.56]; P=0.009; number needed to treat, 9.4). The smokers who received the intervention were also significantly more likely to be using counseling and/or pharmacotherapy at 1, 3 and 6 months after discharge. Using multiple imputation for missing outcomes, the researchers calculated a relative risk for 7-day abstinence of 1.55 in the intervention group compared to the usual care group (95% CI, 1.03 to 2.21; P=0.04).
The study was limited by 19% of participants being lost to follow-up and 22% of those who reported not smoking not providing a saliva sample, the researchers noted. Additionally, the effects of the medication and the phone calls cannot be separated, and the results may apply only to smokers who plan to quit after hospital discharge.
Still, the findings suggest that such an intervention could provide high-value care at relatively low cost and help hospitals meet the Joint Commission's tobacco cessation hospital quality standard. Before widespread implementation, the results need replication, which the study authors are currently attempting in a multisite trial, they said.