Smoking cessation interventions among hospitalized patients: what have we learned?
BACKGROUND
We conducted a structured review of controlled studies on inpatient hospital-based smoking cessation interventions.


METHODS
Electronic searches were conducted with two different search engines, and reference sections of articles located were also reviewed. The RE-AIM framework was used to organize the review around the issues of reach, efficacy, adoption, implementation, and maintenance of interventions.


RESULTS
Thirty-one intervention articles were located, 20 of which included a comparison condition and were included in the review. Overall, a moderate number of studies (13/20) reported on reach, which was highly variable and limited (30-50% in most studies), while few reported on implementation (7/20). Longer term cessation results produced relative risk ratios of 0.9-2.3, with a median of 1.5. Increases in quit rates above the control condition ranged from -1 to 10% (median 4%) among general admission patients and from 7 to 36% (median 15%) among cardiac admission patients. Studies with a dedicated smoking cessation counselor and 3-5 months of relapse prevention had a significant impact on cessation rates. Study settings (adoption) were limited to university, Veterans affairs, and HMO hospitals. Maintenance at the individual level was variable and related to the presence of a relatively intensive initial intervention and a sustained relapse prevention intervention.


CONCLUSIONS
Efficacious inpatient smoking programs have been developed and validated. The challenge now is to translate these interventions more widely into practice, given changing hospitalization patterns.
France
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Department of Preventive Medicine and Research, Kaiser Permanente Colorado, 10400 East Alameda Avenue, Denver, Colorado 80231, USA.
Glasgow
R E
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Marcus
A C
AC
D006760:Hospitalization; D006801:Humans; D015397:Program Evaluation / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*