title: Efficacy of a smoking cessation program for hospital patients.
abstract: BACKGROUND
  Hospitalization may be an opportune time to change smoking behavior because it requires smokers to abstain from tobacco at the same time that illness can motivate them to quit. A hospital-based intervention may promote smoking cessation after discharge.
  
  
  METHODS
  We tested the efficacy of a brief bedside smoking counseling program in a randomized controlled trial at Massachusetts General Hospital, Boston. The 650 adult smokers admitted to the medical and surgical services were randomly assigned to receive usual care or a hospital-based smoking intervention consisting of (1) a 15-minute bedside counseling session, (2) written self-help material, (3) a chart prompt reminding physicians to advise smoking cessation, and (4) up to 3 weekly counseling telephone calls after discharge. Smoking status was assessed 1 and 6 months after hospital discharge by self-report and validated at 6 months by measurement of saliva cotinine levels.
  
  
  RESULTS
  One month after discharge, more intervention than control patients were not smoking (28.9% vs 18.9%; P=.003). The effect persisted after multiple logistic regression analyses adjusted for baseline group differences, length of stay, postdischarge smoking treatment, and hospital readmission (adjusted odds ratio, 2.19; 95% confidence interval, 1.34-3.57). At 6 months, the intervention and control groups did not differ in smoking cessation rate by self-report (17.3% vs 14.0%; P=.26) or biochemical validation (8.1% vs 8.7%; P=.72), although the program appeared to be effective among the 167 patients who had not previously tried to quit smoking (15.3% vs 3.7%; P=.01).
  
  
  CONCLUSIONS
  A low-intensity, hospital-based smoking cessation program increased smoking cessation rates for 1 month after discharge but did not lead to long-term tobacco abstinence. A longer period of telephone contact after discharge might build on this initial success to produce permanent smoking cessation among hospitalized smokers.
authors.affiliation: Tobacco Research and Treatment Center Unit, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA. Rigotti.Nancy@mgh.harvard.edu
authors.forename: N A
authors.initials: NA
authors.lastname: Rigotti
authors.forename: J H
authors.initials: JH
authors.lastname: Arnsten
authors.forename: K M
authors.initials: KM
authors.lastname: McKool
authors.forename: K M
authors.initials: KM
authors.lastname: Wood-Reid
authors.forename: R C
authors.initials: RC
authors.lastname: Pasternak
authors.forename: D E
authors.initials: DE
authors.lastname: Singer
mesh_terms: D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D015397:Program Evaluation; D016540:Smoking Cessation