Evaluation of a hospital-based tobacco treatment service: outcomes and lessons learned

J Hosp Med. 2011 Apr;6(4):211-8. doi: 10.1002/jhm.835. Epub 2010 Nov 24.

Abstract

Background: The efficacy of smoking cessation interventions for hospital patients has been well described, but we know little regarding implementation and outcomes of real-world programs.

Objective: To describe the services provided and outcomes of an academic medical center-based tobacco treatment service (UKanQuit) located in the Midwestern United States.

Method: This is a descriptive observational study. Both quantitative and qualitative data of all patients treated by UKanQuit over a 1-year period were analyzed.

Results: Among 513 patients served, average interest in quitting was 7.9, standard deviation (SD) 2.9 on a scale of 0 to 10. More than 1 in 4 had been given an in-hospital medication to ameliorate withdrawal prior to seeing a counselor. Counselors recommended medication changes for 1 in 3 patients, helped 73% set a goal for quitting or reducing tobacco use, and fax referred 56% to quitlines. Six-month follow-up (response rate, 46%) found a 7-day abstinence rate of 32% among respondents for an intent-to-treat abstinence rate of 15%. Post-discharge, 74% made at least one serious quit attempt, 34% had used a quit smoking medication, but only 5% of those referred to the quitline reported using it.

Conclusions: In a hospital setting, interest in quitting is high among smokers who requested to see a tobacco counselor but administration of inpatient medications remains low. Many smokers are making unassisted quit attempts post-discharge because utilization of cessation medications and quitline counseling were low. Fax-referral to quitline may not, on its own, fulfill guideline recommendations for post-discharge follow-up.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Academic Medical Centers / methods
  • Academic Medical Centers / standards
  • Adult
  • Female
  • Follow-Up Studies
  • Hospitalization*
  • Humans
  • Learning*
  • Male
  • Middle Aged
  • Program Evaluation / methods
  • Program Evaluation / standards*
  • Smoking / epidemiology
  • Smoking / therapy*
  • Smoking Cessation / methods*
  • Tobacco Use Disorder / epidemiology
  • Tobacco Use Disorder / therapy*
  • Treatment Outcome